HomeMy WebLinkAboutCAble Street Cut Permits 40 Quail Run TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. �,_ Contractor COX COMMUNICATIONS
Locati3 Address 801 PARKER ST.
Type Work MANCHESTER,CT
06040 CT 06040
, h No. (860)432-5211
Date I nsp Needed
Time Insp Needed Am
Inspected By
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Work in Progress e 4 �e/%rGd�CS
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Date
Town of south Windsor, CT
Perimi" ,~N "` 3367 Street Excavation Permit
Date , 08/08/2002
Expiration Date 08/08/2003
-Descrip:
Location
Applicant '
Name COX COMMUNICATIONS
Q A L RUN
Addr.. 801 PARKER ST. � k CABLE
06040 CT 06040 d
Phone (860)432-5211 u
i dsor the amount of bond
Applicant agree out for any expenses
required and to re mLW rep in connection with this
incurred by the To n e abide by the rules and
permit and that ap 1 ' h
u � outh Windsor's Street
regulations for per y
Cut Permit Manual . �.
O 0
* PERMIT ALL TIMES.
Issued by
Inspected By
Date Completed
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skP'pg 07 02 11 : 41a Witch Ent. Utility Div 4138210955 P. 1
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
+ � TOWN HALL 33
1540 SULLIVAN AVENUE rC C
C� SOUTH WINDSORF CT
Name of Firm C Phone No. 1Z(00 -S1;2 - `5 ?Z tg3 Q
Address of Firm ll n L i`1-ze i 4 t?m�� �-
Location of proposed work_ U-h ?�Ii jF1 c'li (ZIL13
Describe fully nature of permit requested s-,A;6
Starting date OJeArS Approx.time for completion
Call Before You Dig No. 30 0 t 5(e 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
( )Cash()Check #
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: kas-e let,- Date:
Title: ` IkZA D.L.#:
PERMIT SHALL BE KEPT ON 7OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
Rug 07 02 11 : 41a Witch Ent. Utility Div 4138210955 p. 2
Mass: 888-344.7233
Fx Mars
DIG 2002 3201566 CLEARS 8/12 AM
Mass 10#17930 NUMBER ON
AM
Conn:800.922-4455
Fx 203 248-6448
Contractor 81167 CITY
DATE
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HANGS IF DIFFERENT CATV WORK
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