HomeMy WebLinkAboutCAble Street Cut Permits 6 Tuttle Circle TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor COX COMMUNICATIONS
LocationA�V�Mb*ftWAddress 801 PARKER ST.
Type Work AVOW ',MANCHESTER,CT
06040 CT 06040
No. (860)432-5211
Date Insp Needed sp c�
Time I nsp Needed
Inspected By
Work in Progress
s �
�, — Date T-�
PeY*ii_ o. 3275 Town of South Windsor, CT
Date 'w 04/25/2002 Street Excavation Permit
Expiration Date 04/25/2003
Descrip:
Applicant Location
Name COX COMMUNICATIONSy� TTT CIRCLE
Addr. 801 PARKER ST.
06040 CT 06040 ' �` CABLE
Phone (860)432-521 1 � °� .
Applicant agrees tb h k or the amount of bond
required and to re i m u` o hf r any expenses
incurred by the Town f�Yt pa connection with this
permit and that applic,a an ide by the rules and
regulations for permi spa � ' f th Windsor 's Street
Cut Permit Manual . j e
w..
* * PERMIT `. L TIMES.
Issued by
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No.
Address of Firm tan 6 M ,
Location of proposed work-
Describe
Describe fully nature of permit requested �. �5-,--1 C,:t-I-- LiAj
Starting date 7 aZ ApproX time for commnr.n J 1 l
Call Before You Dig No. �Co�iTO/cJ / - -..._ ._. ""...''.``.�
�_Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
t co
wo es of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$ 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
CTI
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNE ON WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. OUTLINED IN THE
Signed: 'L Date:
Title: A D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
d88.344-7233
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NUMBER ONN AM
Conn:800-922-4455
Fx 203 248.6448
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