HomeMy WebLinkAboutCAble Street Cut Permits 122 Gail Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 6 Contractor COX COMMUNICATIONS
Location Address 801 PARKER ST.
Type Work WCLE" MANCHESTER ,CT
06040 CT 06040
, 5r (860 )432-5211
Date Insp Needed s ?l 316,
Time Insp Needed
Inspected By
Work in Progress p
P'1IR'l, Date
-..Ref rrii �
°�_ . 3326 Town of . South Windsor, CT
Dade 06/21/2002 Street Excavation Permit
.- Expiration Date 06/21/2003
Descrip:
Applicant Location
Name COX COMMUNICATIONS I NE
Addr. 801 PARKER ST.
06040 CT 06040 ABLE
Phone (860)432-5211
Applicant agrees t d or the amount of bond
required and to reim � th r any expenses
incurred by the Town fo en pai I�i connection with this
��rr
permit and that appl i 1 'ir t ""
��� i de by the rules and
regulations for permi ine n �t 8 uth Windsor's Street
Cut Permit Manual . ,
tl'q'6#. 1t g y
* * PERMIT TO LL TIMES.
Issued by �. (ZNA G,
Date Completed Inspected By �,.�
APPLICATION FOR STREETCgVATI N PERMIT
,�a. •. TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT --
b�" 1� TOWN HALL
1 1S40 SULLIVAN AVENUE
SOUTH WINDSOR, -
� CT
WIq1VL-7�
Name of Firm Q
Address of Firm Phone No, (dQ
Location of proposed work M
Describe fully nature of permit requested 1; -
Starting date d D
Call Before You Dig No. po d a/ p} Approx.time for completion _
Traffic Services Control No.
Show sketch of proposed work or furnish •J
two copies of separate drawing To be filed out by Town of Souk Windso
Indicate North Pavement jg
-- Prop.size of cut
No, cuts
Amt. of Deposit$ b
()Cash()Check
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
$
Applicant is responsible for contacting Amt. Due Town
the Police De t. and C.S.Y.D. by
date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNEMON
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS THE TOWN OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. AS OUTLINED D I THIS
IN THE
Signed: , Q�
Title:
PERMIT SHALL SE KEPT ON JOSSM AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
M Mass: 888-344-7233
Fx
Mass l #1.930 DIG SAFE 2002 2 501 647 CLEARS b�2 „ p�
MasslD#17030
NUMBER 7:00
Conn:800-922-4455 AiVI
Fx 203 248-6446
Contractor#1157 CITY )
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DATE
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