HomeMy WebLinkAboutCAble Street Cut Permits 42 Old Farm Roa i TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3390 Contractor COX COMMUNICATIONS
Location 1r ` Address 801 PARKER ST.
Type Work CABLE MANCHESTER,CT
""' 06040 CT 06040
n (860)432-5211
Date Insp Needed
4-9
Time Insp. Needed
C
Inspected By
Work in Progress
SO R G AQ �in/1 Date
PeMit;,No. 3390 Town of South Windsor, CT
Date 09/13/2002 Street Excavation Permit
Expiration Date 09/13/2003
Descrip: INSTALL CATV LINE 42-68 O ROAD
Applicant Location
Name COX COMMUNICATIONS L RM ROAD
Addr. 801 PARKER ST.
06040 CT 06040 k CABLE
Phone (860)432-5211
1
Applicant agrees t Win sor the amount of bond
required and to reim T or any expenses
incurred by the Town f to epa n connection with this
permit and that appl a bide by the rules and
regulations for permi i "i' uth Windsor's Street
Cut Permit Manual .
� a �
a x 1
* * PERMIT T ALL' TI'MES.
Issued by �� � � e
Date Completed Inspected By -� d�
'ep 11 02 04: 13p Witch Ent. Utility Div 4138210955 p. 1
APPLICATION FOR STREET EXCAVATION PERMIT
DSO : TOWN OF SOUTH WINDSOR o�� -
�,°� PUBLIC WORKS DEPARTMENT
�a TOWN HALL
v
p� 1540,SULLIVAN AVENUE
SOUTH WINDSOR, CT
Name of Firm C O?G Phone No. 12 GO -S!2
Address of Firm t _n ti=e Cm
Location of proposed work 4.2-- !e X 0/4 F&rr t 2�
Describe fully nature of permit requested :1: ; i_„u 6
Starting date Approx.time for completion a rY1t.Lf r
Call Before You dig No. 2 eb 13961974 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement trot
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
()Cash()Check #
D� Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt.Due Payee$
Amt. Due Town $
Applicant is responsible for contacting by date
the Police Dept. and C.B_Y.D_
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECT ION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: 3_ Date:
Title: �e mA D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Pennits\Street Excavation Permit.doc
*ep 11 02 04: 13p Witch Ent. UtilitU Div 4138210955 p. 2
Mass: 888-344 7233 �./�O Q�Q CLEARS 3 7'00
FxT81-721-0047 DIG SAFE OO� '5 J 8 ON 9/! AM
Mass ID#17930 NUMBER
-4455
R 203 0 6-6248
Fx 203 248.6448
Conlrador#1167 CITY
DATE
STREET
�-)7IO2 ADDRESS
/a
ROSS ST
HANGE IF DIFFERENT CATV WORK
2411
ARE
A MA
RKED
RKED ? YES
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