HomeMy WebLinkAboutTelephone Street Cut Permits Petersen Wa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No Contxact'or WETI-T B tSR;
Location �LD CONST CO
0*09wi@ WAPPING CHURCH .1k3dress: 1 WELLS >.ROAb',
Type Work TELEPHONE
S ET,HERS'FLE D,;CT:::::>06109
Phone , (86.0,5 9 ,9>224
Date Insp Needed —(,Jill Jgkc yX.
bate insp ` _
Time Insp Needed
-------- Time I��
Inspected By
Work in Progress
Permit No. 4266 Town of South Windsor, CT
Date 08/11/2006X.1 Street Excavation Permit
Expiration Date 08/11/2007
Descrip: INSTALL AT&T CONDUIT F'A'QM`P ,r-#:2'5.,2 ``;''";.'. •:.;.,
Applicant Lo a lion
Name WETHERSFIELD CONST CO P ERSEN WAY'p W.,2.�PPT4kG 4"URCH
Addr. 1 WELLS ROAD
WETHERSFIELD CT' Ie of orF� 'ELEPHgNE
Phone (860)529-5224
Applicant agrees to furi�� k1 the xwn ref South Windsc+ the amount of bond
required and to reimburse floeocuSz�utk� .IiaSr�z fp ,: ny e.t�pEnses
incurred by the Town:: f:rrr',Ma,:%At6,nanc`e"'or"r'epair`'0stvbt eiii'lxi>i:dbnn.e.ctiQn with this
permit and that applicant is fhiif' r� Ckl'i a 3'de ,by t 'e rules and
regulations for permi6..s as:. o t`l;_ine ;'.x:::: e ;TdW.Wi>`of SSsCt'h.43: 'ds'or's Street
Cut Permit Manual.
* * PERMIT TO ''SE =:KEPT,;O '7O8...:'S:Z.T AP.:.AUSn:;:TTME'S.
Issued by ----Jy
pe --
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR 4
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm t,L`_ /aC7 ICIr�' s
Address of Firm / 1L—«s Phone No. �L� S Z 9 - 5_z e
Li- h << 7-
GEC l o q
Location of proposed work 7t h s v A - A,
Describe fully nature of permit requested /ti S. 7-4t c
7
7 �CA /2 �,n-ODD C=o D�.�r/ /N /'—ei1�
Starting date
Call Before You Dig No. ?DDT z U _?o 4- Approx. time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out b
Indicate NorthLy
-
Town of South'Windsor
Pavement Cut
No.cuts
EsL*Size of Perm.Patch(s)
Est Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
_ Final Billing
L I-DfzAn7 TAM
J Amt Due Payee
Amt.Due Town
By
Applicant is res onsible for contactin
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 REIMBU
RSE 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 OUTLED I THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: ✓ ��� �� C.
Date:
Title: (i r<< �� 1;��_tiT
Driver's License M C i %7¢133 7 /o
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
TOWN Ot:SOUTIf WINDSOR
ENGINEERING DEPARTMENT
ADDRESS PERMIT NO, SHEET
OF
UTILR7ES INSPECTOR TEMP.PATCH DATE
INSPECTOR COMPLETION DATE
------ ----+
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14- ------------- ------
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nn''ni me Tina
PREP JOE CALVO JR RECM
APP._ � ��"-6��_ �`�' 06 COMPLETED
WORX
203-238-5661 TITLE DATE TITLE DATE TYPE DATE BY TITLE
BILLING BILLING TO6 CABLE DATE CABLE DATE
�t&t START —. COMP. —
FROM CONST. DATE CONST. DATE
NOTE., ALL UTILITY LOCATIONS ARE APPROXIMATE
AND SHOULD BE VERIFIED IN FIELD.
r
j
EX. CABLES
PROP 2-4"
P TYPE "B"
rr ., • !
\ \ G4� POLS/252
v�
WAPPPING CHURCH p
tDETAIL POLE#
POLV#2451
APPROXlh
TOTAL TR
o¢� D.F. 4 1
i 4 UNIT 4"
WOODED
BARRICADE
POLE/17487 NOTE:ROAD DOES NOT GO THROUGH AS SHOWN ON
CONDUIT PLATES(CONFIRM NEW NAME).
0
$POLSp2794
POLE/28800
YANBOLE /2
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