HomeMy WebLinkAboutCAble Street Cut Permits 158 Tumblebrook ' TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor COX COMMUNICATIONS
Location AllAddress 801 PARKER ST.
Type Work MANCHESTER,CT
06040 CT 06040
o No. (860)432-5211
Date Insp Needed I 4 fo a
Time I nsp Needed A It, A a,sa pol
c
Inspected By '
Work in Progress A02
'Jul' 1-1/
p � F
'S Date
Permit jjw*:"`"' . 3368 Town of South Windsor, CT
Date 08/08/2002 Street Excavation Permit
Expiration Date 08/08/2003
Descrip:
Applicant . Location
Name COX COMMUNICATIONS XT LE BROOK DRI
Addr. 801 PARKER T.
06040 CT 06040 k CABLE
Phone (860)432-5211
Applicant agree dsor the amount of bond
required and to re m ou Sur for any expenses
incurred by the To n en re qrK in connection with this
permit and that ap 1 1 h abide by the rules and
regulations for per u outh Windsor's Street
Cut Permit Manual .
� k
* * PERMIT Qr ALL TIMES.
Issued by eAL lk
Date Completed Inspected By
R6;g 07 02 11 : 42a Witch Ent. Utility Div 4138210955 p. 3
APPLICATION FOR STREET EXCAVATION PERMIT_ TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
s
a TOWN HALL
1540 SULLIVAN AVENUE
%ki SOUTH WINDSORf CT
F WA vc- IS
Name of Firm C d C' 11 C I b Z 420 —sly
Address of Firm Phone No.
_ M. CT
Location of proposed work___1`o T.51 aw..6r�x�tc D�•
Describe fully nature of permit requested L„A; •—
Starting date Approx.time for completion_ f-3, 40. �ret.L{-�
Call Before You Dig No..20 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.acts
Amt. of Deposit$ by
e
Y�•J` p` ()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: Date: 0 ,
Title: D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
Rug 07 02 11 : 42a Witch Ent. Utility Div 4138210955 p. 4
3201562 8/12
Mass: 888-344-7233
Fx 781-721-0047 DIG SAFE oO CLEARS 7:00
mew10#17430
NUMBER ON AM
Conn:800-022-4455
Fx 203248-5448
CanlraIXor Yt 1167 - CITY
DATE t[Jb c, S/V IbF/LL Y
STREET
X�y
ROSS ST
p' IIW ANGE IF DIFFERENT CAN WORK
„�?,���. ,:x�•{.:,;. ia4,�v� _ �.{fir
AREA MARKED ? YES
t
c
...... ............--