HomeMy WebLinkAboutCAble Street Cut Permits 211 Skyline Dri TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3498
Location 0211 SKYLINE DRIVE Contractor COX COMMUNICATIONS
Type Work CABLE Addre 801 PARKER ST...
MANCHESTER: CT
06046 CT 06a:4o
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Permit No. 3498 Town of South Windsor, CT
Date 05/13/2003 Street Excavation Permit
Expiration Date 05/12/2004
Descrip:
Applicant Location
Name COX COMMUNICATIONS t2'11„$KYLIN9 DRIVE
Addr. 801 PARKER ST.
06040 CT 06040 Type of: Work CAST�E>
Phone (860)432-5211
s. y
Applicant agrees to; furnisks the Pta �b �Fcxuh Wind Che amount of bond
required and to reimburse thel To�,xa ayc� tifSi3$rx fqr aziy expenses
incurred by the Towi or maaiitenance or repair 'Work in bOntyect ion with this
permit and that app1aC'ant is ::fame ' xnzX dk "yaall abide: by the rules and
regulations for permits as tau?tune i of South 'W.ihd'sor's Street
Cut Permit Manual.
* * PERMIT TO E. NEAT ON 6t i'SITE AT AEI TIk.
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Issued byTitle
Date Completed _ � � --✓� Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
�b TOWN OF SOUTH WINDSOR
a - PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORF CT
FEE $25.00
Name of Firm
ir
Address off Firm- Phone No.
'Z_p ► �Yrt P ,,� v,
Location of proposed work i
Describe fully nature of permit requested
Starting date rs _&;ht. p 3
Calf Before You Dig Na. p 1 3 � .Approx,time for completion
Traffic Services Control No.
Show sketch s proposed work or furnish To be filled oert f�v Town of South Windsor
two copies of separate drawing
Pavement Cut
Im ca`e 'forth --"
Prop.size of cut
No.ads
Amt.of Deposit$ by
+- S� ()Cash ()Check #
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town $
Applicant is responsible for contacting by
Lithe 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
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PER SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECT ION WITH THIS
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. MITS AS OUTLINED IN THE
Signed: � � _ Date: --� �
Title: V
D,L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit,doc
Mass: 888-344-7233
DigSafe.com Pswrd DIG SAFE
023WE MaSSIDN CLEARS
17930 NUMBER 2003 . 200UZ2 ON -00
Conn:800-9224465 7.
CBYD.Com Pswrd
WITCHEQUIP
Contractor#1167 CITY
DATE
S isI STREET
-./0 3 ADDRESS
ROSS ST
NGE IF DIFFERENT 2411 CATV WORK MARKED ? YES
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