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HomeMy WebLinkAboutCAble Street Cut Permits 97 Sally Drive I TOWN OFk SOUTH WINDSOR INSPECTION REPORT a. Permit No. - 90 Contractor COX COMMUNICATIONS Location Address 801 PARKER ST. Type Work CABLE MANCHESTER,CT 06040 CT 06040 &ene (860)432-5211 Date Insp Needed 7 s Time Insp Neededj� y� Inspected By FAH Work in Progress .t a t� M k- Date 12�i�b2 a Peilo. 3290 1-own of South Windsor, CT ' Date 05/10/2002 ji Street Excavation Permit FExpi "ation Date 05/10/2003 Descrip: INSTALL CATV LINE Applicant } Location Name COX COMMUNICATIONS �� L DRIVE Add r. 801 PARKER ST. , rA 06040 CT 06040 � CABLE Phone (860)432-5211 Applicant agrees h n if4or the amount of bond required and to reim u ` o th r any expenses incurred by the Town a an pai i connection with this permit and that appli an ide by the rules and regulations for permi 1 f, th Windsor's Street Cut Permit Manual . * PERMIT T 6 , 1 LL TIMES. ..c � yr^ � °x � •��., Issued by J. P�(G�A , rn t Qf�r�� EtiG. Date CompletedInspected By it APPLICATION FOR STREET EXCAVATION PERMIT 43,-9Q .. TOWN OF SOUTH WINDSOR - --- PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORf CT FEE $25.00 Name of Firm © C1 Phone No. (00 — Address of Firm Location of proposed work It dr Describe fully nature of permit requested Starting date — / Approx.time for completion Call Before You Dig No. 3 Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop. size of cut No. cuts � Amt. of Deposit$ by ( )Cash ( )Check # G 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: ktle `` � 'L Date: S�0 nn -0z Title: �..-1A cx,Xn D.L.#: PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc mass:888-344-7233 Fx781-721-0047 DIG SAFE 2002 � t /� j/ CLEARS t j 7:00 Mass JD#17930 NUMBER l 1563 7 4 4 ON T� AM Conn:800-922-4455 Fx 203 248.6448. Contractor#1167 CITY DATE STREET /�--�Q2 ADDRESS AAA .moo Lonm, CROSS ST SrA4j4j2yL LW Cox. CHANGE IF DIFFERENT CATV WORK Qnur"6d- 24" TQ a)n AREA MARKED ? YES JAf-*4 P - -- - - - _ --- -- -- - -- - - _._ - --