HomeMy WebLinkAboutCAble Street Cut Permits 235 Orchard Hil TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit .No. 2683 Contractor COX COMMUNICATIONS
Location 0235 ORCHARD HILL DRI Address 801 PARKER ST.
Type Work CABLE
MANCHESTER,CT
06040 CT 06040
Phone No. (860)512-5000
Date Insp Needed Date Insp`.,_21
Time Insp Needed
Time I n s.p,='•
Inspected By �..
Work in Progress Cep-r,�e�roz. i��cv1� , c
/��t.c.I 5�r�� G_, •�9.
Input Date
er at%No.
' 2683 Town of South Windsor, CT
Dame 05/10/1999 Street Excavation Permit
Expiration Date 05/09/2000
Descrip: REPL4CE HOUSE SERVICE CATV
Applicant ,rn Location
Name COX COMMUNICATIONS , $ °° 25 ARD HILL DRI
Add r. 801 PARKER ST.
06040 CT 06040 CABLE
Phone (860)512-5000 ,a� "v
Applicant agrees t� fur � t � ef « 1ncsor the amount of bond
required and to re�mb er �T c--A, r any expenses
incurred by the Town ,.f r'r � ,�ne cep �` i connection with this
permit and that appi itcam � a V�w66i de by the rules and
regulations for permv,ts 1: To m "°S th Windsor's Street
Cut Permit Manual .
NZI
* PERMIT EP T t �TIMES.
Issued by
Date Comp l(et�d ted By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �� � Phone No. 57 a — 5-?w
Address of Firm ar er ST Hr�,,r-Zesfe ✓'
Location of proposed work _:235' 07d 0"ar-st 14,7/ Ur
-
Describe fully nature of permit requested a.te ice r� ucr. TV
Starting date AIW2000 5-08 Approx.time for completion 30
Call Before You Dig No. S I3 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No.cuts
Amt.of Deposit$ by
i ()Cash ( )Check#
i
i
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 CONNECTION 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: Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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