HomeMy WebLinkAboutCAble Street Cut Permits 132 Rockledge D R
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 338 Contractor COX COMMUNICATIONS
Location 4 _ Address 801 PARKER ST.
Type Work RKE` 3:9 a MANCHESTER,CT
06040 CT 06040
SJ�h No. (860) 32-5211
Date Insp Needed ��
Time I nsp Needed ' 11; -� ,
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Inspected By
Work in Progress
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Permit'No �= 3383 Town of South Windsor, CT
-Date - \ 08/28/2002 Street Excavation Permit
Expiration Date 08/28/2003
Descrip: INSTALL CATV LINE
Applicant Location
Name COX COMMUNICATION AN
LEDGE DRIVE
Addr. 801 PARKER ST.
06040 CT 06040 o k CABLE
Phone (860)432-5211
Applicant agree ao t h tT W ndsor the amount of bond
required and to reiplau e ou dui for any expenses
incurred by the To in re 4oK in connection with this
permit and that ap 1 h h''K abide by the rules and
regulations for pe a Hof South Windsor's Street
Cut Permit Manual . rrr
1
* * PERMIT fi T ALL TIMES.
Issued b '�•�' ` " • r-�
Y tle
Date Completed Inspected By
Aug 26 02 02: 08p Witch Ent. Utility Div 4138210955 p. 1
APPLICATION FOR STREET EXCAVATION PERMIT
SO , TOWN OF SOUTH WINDSOR ---
� � PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 1
W
Name of Firm 0K Phone No. 17 Go -S
Address of Firm 4'7 n =21 A toA:d l
Location of proposed work J3d ItocK(e-le Lf2
Describe fully nature of permit requested =K., 3: r Lieu S ,,
Starting date C t rS Approx.time for completion I- QA- :K �WLO. MLtkr
Call Before You Dig No. a oo , S b6 331 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
Pavemgtt Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
5 ()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: e-�L t:'L� Dater _
Title: Ca, ,,AmA D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permit \Street Excavation Permit.doc
Aug 2G 02 02: 08p Witch Ent. Lltility Div 4138210955 p. 2
Mass: 888-344-7233 CLoNRS9 700
FX 781-721-0047 DIG SAFE 8/2mass lD#17930 NUMBER 20023500331 AM
Conn:800-922-4455
Fx 203 248-6448
Contractor#1167 CITY —.5,004h i"11'e
DATE STREET
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rv,CHANGE IF DIFFERENT CATV WORK
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AREA MARKED ? YES
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