HomeMy WebLinkAboutCAble Street Cut Permits 58 Sharon Drive w
r TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3541 XXX
Cont. :aC'tor COX COMMUNICATIONS
0058 SHARON DRIVE
Address' ': 801 PARKER ST,.Type Work CABLE F-7
CACHESTER CT
CY�040. CP,..MAO
Pl.ihoiie No { 60)432 52`11
Date Insp Needed Date" Insp
Time Insp Needed 777�7-
Inspected By —
Work in Progress _ "'
Input.,, Date
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Permit No. 3541 Town of South Windsor, CT
Date 07/081/2003 Street Excavation Permit
Expiration Date 0'7/07/2004
Descrip: INSTALL CATV LINE,
Applicant LoCat3on
Name COX COMMUNLCATIONS &,:RON RIVE
Addr. 801 PARKER ST06040 CT 061040ort, GZIBJE a
Phone (860)432-5211 :
k
Applicant agrees to :fFxTnx.sla the :rTRzx, i'ttk� Windsor the amount of bond
required and to reimburse tks down .c€` qt} t� lcidpx fior axy expenses
incurred by the Town Or Mai t nance or rep��r wox 'n ccnziectyun with this
permit and that applicant is "fatttili'ar i1 grad ,w11..1 ab24e:'by t:he rules and
regulations for, permits as out lined in tk 4aWSi of S'6uth Windsor's Street
Cut Permit Manual.
* * PERMIT TO BE""KEPT QN 708 'SITE AT ALL';,.TTMES.
p Q
0��C/l
Issued by ,T'i t 1 e ::` -------- —
Date Completed — �-
MA-
Inspectedr-
- By — �L�
APPLICATION FOR 3 y I
STREET
�d EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR -
PUBLIC WORKS DEPARTMENT
TOWN HALLT
1540 SULLIVAN
} AVENUE
VENUE
C� SOUTH WINDSO
R,gCT
Name of Firm
Address of Firm d Phone No. 1 1 �2('
Location of proposed work
Describe fully nature of permit requested F-
S arting dateG !�
Call Before You Dig No. Z Approx.time for completion _
Traffic Services Control No. wt�
Show sketch of proposed work or furnish J
two copies of separate drawing To be ful p b Town of South Windsor
j Indicate North v e
++ -- Prop.size of cut
No. tests
Amt. of Deposit$ b Cash()Check #
Cut size after Perm. Patch
No. Cuts
Final Billing$
i
Am , aYr�e
Amt. Due Town $
AOClicant is responsible for contacting
`e'ice Dept.and C.B.Y.D, by date
AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMB
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNE
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS
ASRSE *f fE TOWN OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. CnON WITH THIS
OUTLINED IN THE
Signed:
Date:
Title:
D.L.#:
-E?; 1,SHALL BE KEPT ON]OSSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
88e-344-7233 p.
Dlj33%.C"PSW(d
0233E Mass ID# DIG SAFE
17930 NUMBER CLEARS
Corn:800-922-4455 2003 2802595
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AlrTCHEQUIp 7.vIVJ
Gontraver#1167 CITY
DATE -rol-
/03 STREET
ADDRESS
.......................
RIOSSST
ANGE IF DIFFERENT
24" CATV WORK
0
I - , MARKED ? YES
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