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HomeMy WebLinkAboutCAble Street Cut Permits 37 Sea Pave Dri TOW7 Op SOUTH lermit No. WIN DSOR INSPECTION REPORT Location 3602 ' Type W ' T 0037 SEA PA* ROAD Con tral't' or COX Cf3fvM ork CABLE a1' dr r?UNICATIONS �.ANCHE t16Q40 CT No „06040 Ptlarie 'Date Insp Needed ($ '0)432 52 11 Time Ins p Needed Tamp Iri .' JS Inspected BY Work in p --a�/1 rogress /� CLIf Input, . Date -- o V _ - i Permit No. 3602 Town of South Windsor, CT 1 Date 1�0/02/2003 Street Excavation Permit Expiration Date 10/01/2004 Descrip: Applicant Locat7an Name COX COMMUNICATICkNS " OQ37 SEA PAV$ .ROAD Addr. 801 PARKER ST. 06040 CT 06040 Ty Ze o£ :0t*k,CAS Phone (860)43,2-5211 Applicant agrees to`ftirnih.'the T:sxwn.,ref„South Winds:os the>. amount of bond required and to reiimb�l ss, the Tov7Y1 h 5buth k7 nc3's;or £Oz arzy :..expenses incurred by, the Town fs?r max�t'enant�"or 're'pair tiork lxj! Ct)nr�ecti on with this permit and that appllcan't ib famrl h .by the rules and regulations for permits as outlined �# of South W.�.,zidsor-s Street Cut Permit Manual. * * PERMIT TO SE,;I-EPT ON"�TQB �,.xTE AT ALL'.T•IM�S. Issued by C�'1 Y l — .i t 1 e --------- Date Completed Inspected B r• t APPLICATION FOR STREET EXCAVATION PERMIT _ Aa0.O : TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL �D� 1540 SULLIVAN AVENUE (%I) SOUTH WINDSOR, CT Name of Firm © Phone No. 40 -S L� S Zqo Address of Firmr. �C�dt'id M -X - Location of proposed work 3? $,;A v cer rw�. $ura{,atir Describe fully nature of permit requested :�,., a;,-; , ; -,;r,, L�� Starting date d. S& a c.1-car a tc 3 Approx.time for completion Cali Before You ig No e0 Traffic Services Control No. Show sketch 0s proposed work or famish two copies of To be filled out v Town of South eparake drawing Pavement --ej Indicate North Prop.size of cut No. cuts s Amt.of Deposit$_ by 4- S� ()Cash()Chedc# Windsor Cut size after Perm. Patch No. Cuts Final Billing$ Amt. Due Town $ Applicant is responsible for contacting A the Police Dept. and C.B.Y.D. date 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 AND REGULATIONS FOR PERMITS AS OUTLINED IN THE PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed:—t - ;� Date: � Title:— D.L. : PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc .c � l V S ( O C r♦ Mass:888-344.7233 ' DI9Sate.COMPswrd DIG SAFE 17930 NUMBER Mass 2003 4001462 CLEARS Conn:800-922-4455 ON i p/3 793o 7:00 CBYD.Com Pswrd � WRCHEQUlP Contractor#1167 C I 1 1/ J F �,1� /,Nr m DATE /03 STREET ADDRESS ? -- Pz,q-- p � s lei o 3 -- r. 24" CATV WORK MARKED ? YES law t u��re r •.� p .r t a.•Y e4�: 'AS C Qv vz i� Iir