HomeMy WebLinkAboutCAble Street Cut Permits 195 Quarry Broo TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3408 Contractor COX COMMUNICATIONS
Location � ,�: Address 801 PARKER ST.
Type Work CABLE MANCHESTER,CT
06040 CT 06040
NC»Ph e No. (860)432-521 1
Date I nsp Needed lbe I
T i me I nsp Needed
Inspected By
Work in Progress
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t _r- - .. Date /0
'OeVlr t No. 3408 Town of South Windsor, CT
04ta 10/01/2002 Street Excavation Permit
Expiration Date 10/01/2003
Descrip: INSTALL CATV LINE
Applicant Location
Name COX COMMUNICATIO 15 Q RRY BROOK DRI
Addr. 801 PARKER ST.
06040 CT 06040 rk CABLE
Phone (860)432-5211 '
Applicant agre , s till indsor the amount of bond
required and to r h ` So rmlq r for any expenses
incurred by the T ai r r o k in connection with this
permit and that a it 1 abide by the rules and
regulations for p rp4 South Windsor's Street
Cut Permit Manual . k d
c
* * PERM a T ALL TIMES.
Issued by � �A . cot 1 e r--c
Date Completed Inspected By
P. 1
APPLICATION FOR STREET EXCAVATION PERMIT -
<;® : TOWN OF SOUTH WINDSOR ---
t PUBLIC WORKS DEPARTMENT O
a� TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT W),t Ve
Name of Firm CA�no&l Phone No. �2(3 S a S �57Q
Address of Firm t:n i *)NCP>AQ� M CT_
Location of proposed workJ99 dLAoko�]SraoK hr.
Describe fully nature of permit requested �i _ rtT'4` `iAj+T
Starting date nigarsApprox.time for completion `
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out 6v 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: - s'I - Date:
Title: w=A
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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