HomeMy WebLinkAboutDriveway Street Cut Permits 266 Quarry B TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. w. ., Contractor COX COMMUNICATIONS
Location allow Address 801 PARKER ST.
Type Work
MANCHES TER,CT
��t 06040 CT 06040
Y� SDIo. (860)432-5211
Date Insp Needed 4% 4nabO
Time Insp Needed 3•S P
Inspected By
Work in Progress
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—i ir1L Date
Pe►%yt Flo. 3341 + Town of South Windsor, CT
Date 07/10/2002 Street Excavation Permit
Expiration Date 07/10/2003
Descrip:
Applicant Location
Name COX COMMUNICATIONS tu Y BROOK DRI
Addr. 801 PARKER ST.
06040 CT 06040 DR'Z'V` WXY CAr✓
Phone (860)432-5211
Applicant agrees 1 t sor the amount of bond
required and to rei b T ut &n or any expenses
incurred by the Tow t na ep n connection with this
permit and that app iO4 11
a bide by the rules and
regulations for perm ' t outh Windsor's Street
Cut Permit Manual .
* * PERMIT ALL TIMES.
Issued by a i e
....
Date Completed Inspected By ,,►., �.e �____ ��/
APPLICATION FOR STREET EXCAVATION PERMIT
SO TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
J►`� TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT -j
&.4 t V C_j
Name of Firm Phone No.
Address of Firm M ' Cr
Location of proposed work
Describe fully nature of permit requested �: >i r�� C=rtT'v' i_,ti.;rr
Starting date Approx.time for completion
Call Before You Dig No. 3 Traffic Services Control No. J
Show sketch of proposed work or furnish To be filed 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
s� ( )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: _sat 't_ Date:
Title:, !L024 D.L.,'#'
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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Mass: 8W344-721-0047233 80 ors 7/1 w
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Mass IN 17930 NUMBER AM
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