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HomeMy WebLinkAboutCAble Street Cut Permits 31 Wentworth Dr AT TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3529 » ; X.. Location 0031 WENTWORTH DRIVE Contra COX,::Ai�KE CATIONS .AtldreS:s€ 801: PARIE,ER Type Work CABLE N -� IyIANCHES'TE: C.T 46040 �CT::..060.40 Ph.one No' E$6'0} 3,2t5271 Date Insp Needed ------- Dates isp 6 > Time Insp Needed ----- — Time Insp Inspected By jj Work in Progress Input — Dat 1.e --— �T— Permit No. 3529 Town of South Windsor, CT Date 06/17/2003 Street Excavation Permit Expiration Date 06/16/2004 Descrip: INSTALL CATV LINE.' A. Applicant LocaC 'on Name COX COMMUNICATIONS 0p31. ,WENTWO{THDRIVE Addr. 801 PARKER ST. 06040 CT 06040' pe Qf. ATork CA$T,E Phone (860)432-5211 Applicant agrees to' fusnisn the To,v,=ri t� .�cysiC;h Windso'.; the,:.,amount of bond required and to re mbuzse!:the.;,TOWri gtath tt3 l s;gr QT any'exgenses incurred by the Town for ttta�#xtnanae'or Yepair'wor#� cpnn;e;ctSon with this permit and that applicant's 4Tftil r �rratYi `and W `il aid"i:de by"the rules and regulations for permits as outl in:edza the ;Town of South Windsor's Street Cut Permit Manual. * * PERMIT TO''13E T<EPT ON'T©B SFTE AT:;, Th, TIMES. I Issued by .... Date Completed Inspected B � 7un 12 03 12: 37p Witch Ent. Utilit�i Div 4138210955 p. l APPLICATION FOR STREET EXCAVATION PERMIT S� _. TOWN OF SOUTH WINDSOR /UD PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORf CT wa 1VEIs Name of Firm, Phone No. O Address of Firm_ t,]. )'ro9j A '_ Location of proposed work 31 Ufn lbrj'k All Descri)e fuliy nature of permit requested i < `[` ` u,u Starting date ISp _Y Approx.time for completion — ;gyp Cali Before You Dig No.,2. 03.2- O J Traffic Services Control No. J 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 j Amt.of Deposit$ by 5 ( )Cash ()Check # Cut size after Perm. Patch No. Cuts Final Billing $ s i j Amt. Due Payee$ 'i. Amt. Due Town $ i Applicant is responsible for contacting by date i the Police Dept. and C.S.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 i0(PENSES 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 OlvN; OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: n� Date: 7iZ L e:. n,!!l a D.L.#: PERMIT SMALL BE KEPT ON JOBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc x`k�j,�jea�..c��.�rarr%��».r•���'s'b`F 3u�?f.�`3� 4`4�F� 1 j"'��'C� !'. �`+.�,�,' ,�gs�Ana r�l ���"��� �C���3���r,��4�3��•�g;AF.• � �� J� 2 fie4 1 f fr a .0 ,�e-t� 15P�F'�d.+l' t"4 f f'+�. �t u1'4't 'j�•ait�y] � 3 fUP,- P 3E�wla-ft•�IJ, �3.: � iPf4..M H` ...cY� 4 i kh�: