HomeMy WebLinkAboutCAble Street Cut Permits 229 Skyline Dri TOWN OF SOUTH WINDSOR INSPECTION REPORT 1.3
Permit No. 3127 Contractor COX COMMUNICATIONS
Location Address 801 PARKER ST.
Type Work CABLE MANCHESTER,CT
06040 CT 06040
PhWe No. (860)432-5211
Date Insp Needed
Time Insp Needed .,TI' e; Irispi
Inspected By � '
Work in Progress
Input Date
Perm-i t 40. 3127 Town of South Windsor, CT
pate - 06/06/2001 Street Excavation Permit
Expiratlpn Date 06/06/2002
Descrip:
Applicant Location
Name COX COMMUNICATIONS 0 ,29. 8KYLINE DRIVE
Addr. 801 PARKER ST.
06040 CT 06040 *ype of Wgrk CABLE
Phone (860)432-5211
Applicant agrees to furni r the'. to t:.of S&Uth, Windsor the amount of bond
required and to reimburse the-Town of �Sautth Win'8sor for any expenses
incurred by the Town for tna"�t Genance or r,,.epair work in connection with this
permit and that app l i cant is fami 1 i ar "t4fth and" wi l l` 'abide by the rules and
regulations for permits as out}ihed . in' th+ Town of South Windsor's Street
Cut Permit Manual .
* * PERMIT TO BE, KEPT ON JOS ,SITE, AT ALL TIMES.
r
Issued by _ L T it 1 e ��u'���
Date Completed Oj Z Inspected Byf�r�[ 4..�
�' - APPLICATION FOR STREET EXCAVATION PERMIT #f3i2''1
TOWN OF SOUTH WINDSOR - =-
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Cox Phone No. 5 60
Address of Firm Fit
Location of proposed wo pr'Z
Describe fully nature of permit requested = kS,Arti 41-�{ L,�1
Starting date — —CU i Approx. time for completion (—' QA-A
Call Before You Dig No. AM t�k,301 Lit 3 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$ by
Cash ( )Check#
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: Q� l
9 _�, a�.a Q .�a Date:
Title: D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
$$IUs1iaou rax/61 721-U047
DIG SAFE NUMBER 2001 6-� 3 0 1,3
Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON CO
Contractor#1167 AT 7:00 AM
Date L� /01 EMAIL CITY
• (-.1�✓u AS Q�
STREET ADDRESS �� �,�;,� L�s�L—' pP
�T C.e-t-t
CROSS STREET
CHANGE IF DIFFERENT: WORK: In ailing CATV DEPTH: 24" AREA PREMARKED ?: YES
Utilites Notified:
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