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HomeMy WebLinkAboutCAble Street Cut Permits 117 Tumblebrook TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3080 Contractor COX COMMUNICATIONS Location 0117 TUMBLE BROOK DRI Address 801 PARKER ST. Type Work CABLE MANCHESTER,CT 06040 CT 06040 "Phone No. (860)432-5211 Date Insp Needed Date Insp. 3 v 0 Time Insp Needed Time ins �- Inspected By lr� Work in Progress /Ovx,, Input (! Y �`- Date c1 III I, 3uov -Town of-SOUt-F W1n .so , CT Date 04/10/2001 Street Excavation Permit Exp-1,r awn Date 04/10/2002 Descrip: ; INSTALL CATV LINE-BORING UNDER ROAD Applicant Location Name COX COMMUNICATIONS 01+7 'FUMBLE BROOK DRI Addr. 801 PARKER ST. 06040 CT 06040 �,YPO, of .Work CABLE Phone (860)432-6211 Applicant agrees t©' furir7sh; the , twri' of goUth Wiridsor the amount of bond required and to reimbur.,ae ,i dsor for any expenses incurred by the Town ft malriohan 'i connection with this permit and that applci fmaath arrd,wa11 °abide by the rules and regulations for permi to a , qu:t 1 i neth Taxi of .S,OUth Windsor's Street Cut Permit Manual . * * PERMIT`: kC TO -BE PT 4 JC SITE AT Ask TIMES. I-ssued b �. (CN y Date Completed Ins petted By B ��� _ APPLICATION FOR STREET EXCAVATION PERMIT 3��0 - TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm 6 C� Phone No.��� -S L - rs Ago Address of Firm Location of proposed work Describe fully nature of permit requested = E _ Starting date Approx. time for completion Call Before You Dig No.dLo( I Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Tow two copies of separate drawing n of South Windsor Pavement ►� Indicate North Prop. size of cut No. cuts Amt. of Deposit$ by 4—�� ()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: - - •e Date:_{- '�-C1 Title: D.L.#• PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc -Mass ID#17930 Fax 781-721-0047 �O O � � � `UD��� DIG SAFE NUMBER Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON �-- Contractor#1167 AT 7:00 AM Date Z,/ /01 EMAIL CITY -S STREET ADDRESS -L C.¢- Ae l CROSS STREET L(2 a CHANGE IF DIFFERENT WORK: Installing CATV DEPTH: 24" AREA PREMARKED ?: YES Utilites Notified: C Lw C--rloa-tc-�-- f L (,�; LV ge loci S LQ c.0 ca I tx)Cu"j� (%0) f