HomeMy WebLinkAboutCAble Street Cut Permits 90 Skyline Driv i
TOWN OF SOUTHIWINDSOR INSPECTION REPORT
Permit No. 3571
Location 0090 SKYLINE DRIVE Cont;ra'ctor COX COMMUNICATIONS
Type Work CABLE
Address' 801 'PARKER 'ST.:.
NCHESTER CT '
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Permit No. 571
Town of South Windsor, CT
Date 08/18/2003 Street Excavation Permit
Ili
Expiration Date 08/17/2004
Descrip: INSTALL CATV LINE
Applicant Location
Name COX COMMUNICATIONS OCk9'0 SKYLIN$' DR.IVB.
Addr. 801 PARKER ST
06040 CT 060�0 .' Tze of. Wp �t G�k1BLE
Phone (860)432-5211
Applicant agr es: to fUrnjsh the Town 0f ;5outh of bond
required and to leiitibtirsE; the : owout.h Wzzsdsox PP.r.l aiiy expenses
incurred by the Town f6t, mak-1:9,opanceor repair work 1n::C6nn0,.cti.on with this
permit and that gpplcaiit �s famiTae'lCh;a w111 abide by Ole rules and
regulations for permits as outlined tkle: x4�+htt} "of Soix h,Wjj-id:or's Street
Cut Permit Manual;.
* * PERMIT TO $8 '.KILPt ONdQBIT AT:...�LI TIMES.
Issued by —__—_ VY)— Title
Date Completed Inspected B
., 3571
APPLICATION FOR STREET EXCAVATION PERMIT -
,� � TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
tea TOWN HALL
O 1 1540 SULLIVAN AVENUE SOUTH WINDSO
Name of Firm C1111
-�Ld
Address of It Phone No.Mao — Q
Location of proposed work
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Describe fully nature of permit requested
L(Aj C
Starting date
Call Before You Dig No. oe-g 33 6 d 3.� �prox, bin for completion
.. ._Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing To be tilled out b Town of Sauth Windsor
Indicate North - Pavemen r>t
---- Prop.size of cut
No. cuts
Amt.of Deposit$ by
Cash( Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D, by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION
THE TOWN OF
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PER AS OUTLINED TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. S As WITH THIS
IN THE
Signed: -.I
Date: /,4 0.3
Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
.,Mass: 888-344-7233
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Mass NUMBER 2003 302323 _ CLONRS
DIG SAFE
17930 8/19 7:00
17930
Conn:800-9224456CBYD. — .WITCH
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DATE
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CROSS ST
CNAN6EIFDIFFERENT 24 CATV WORK MARKED ? YES
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