HomeMy WebLinkAboutCAble Street Cut Permits 39 Rosemary Lan r" 1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
Location Contractor COX COMMUNICATIONS
Type Work Address 801 PARKER ST.
MANCHESTER,CT
06040 CT 06040
(860)432-5211
Date Insp Needed
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Time Insp Needed
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Inspected By
Work in Progress
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Date
Pe-f-i' `No. 3347 Town of South Windsor, CT
Date' 07/23/2002 Street Excavation Permit
Expiration Date 07/23/2003
Desprip: CABLE
Applicant Location
Name COX COMMUNICATIONS S Y LANE
Addr. 801 PARKER ST.
06040 CT 06040 p �` ABLE
Phone (860)432-5211 '
Applicant agrees h onod or the amount of bond
required and to reim Lww � . o th r� r any expenses
incurred by the Town on pai i connection with this
permit and that appli t an ide by the rules and
regulations for permi svOh t S uth Windsor's Street
Cut Permit Manual . x
* * PERMIT T LL TIMES.
Issued by ..�
Date Completed Inspected By
J-ul 23 02 10: 58a Witch Ent. Uti1ity Div 4138210955 P. 1
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APPLICATION FOR STREET EXCAVATION PERMIT
A 000 TOWN OF SOUTH WINDSOR ----
�, PUBLIC WORKS DEPARTMENT
TOWN HALL
0� 1540 SULLIVAN AVENUE
C�� SOUTH WINDSORF CT
UJA VE ;
Name of Firm er rrn-kl,'W Od CAMQA5 Phone No. . (a() — 'rs �,(70
Address of Firm
Location of proposed work _-'4g__I�o.SQfYlGtr2i
Describe fully nature of permit requested Diu
Starting dates Approx.time for completion I-3 W o t r rccrKL44t
Call Before You tliq No QQ'/ t�— Traffic Services Controf No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement C
Indicate North Prop.size of cut
No.cuts
� Amt. of Deposit$ by
�S ( )Cash()Check #
D�
(,js' 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 OUTLINE) IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:/�� � _�14
ti Dat Oct
Title: S.a`"r-�� "A Q.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permicdoc
,J.u1 23 02 10: 58a Witch Ent. Utility Div 4138210955 p. 2
Mass: 888-344-7233 -
Fxss1.#17930 DIG SAFE ///��� 3001112
Mass i0#17930 /oO CLEARS 7/2
NUMBER (� 7:00
Conn:800-922-4455 ON
rx 203 248.6448 AM
Contractor#1167 CITY
DATED
- )�/02 STREET
ADDRESS 3
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"4�, ,� �a` AREA MARKED ? YES
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