HomeMy WebLinkAboutReplace catv Street Cut Permits 165 Skyl 800040 --
TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/16/08
GIS ID: 83100165
MUNIS APPLICATION# 200800471 FEE: 25.00
E PIRATION DATE: 04/16/09
APPLICANT LOCATION
NAME: TELE-NETWORKS ADRES I55 SKYLINE DRIVE
ADDRESS: 31 BAKEWELL COURT
OWNER It ESER KATHARINE K
CRASTON,RI 02921 1 K 'LTl"IF DRIVE
PHONE 401-461-8420
SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: REPLtCINGT ' ;;;
APPLICANT AGREES TO FURNISH THE TOWN Q`F SOUTH WlM.D.S0k' F AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURI PIS I3 `I`HE TOWN FOR�hLAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS Fr Iv1I xAIZ>WITH AND WX: L,ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH 1} R S ETAP PFIVIIT MANUAL.
ISSUED BY `
DATE INSPECTED INSPECTED BY
4/16/20082:21 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
w
TYPE OF WORK:
'Yt `
DATE INSP NEEDED: DATE INSP: `�0_
INSPECTED BY:
WORK IN
PROGRESS:_ S L i,,-
AS-BUILT:
INPUT: V` DATE:_(_). Ls1 �l ,
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATIONPERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm LL=�Y° N0TWO Ocs - Phone No.Sgk, gas' Z3o 2-
Addressof Firms I �� �►��L Ci , City 572��I tZ 1 2�''1 Z
Location of proposed work-
.Describe fully nature of permit requested_
Starting date �`—0�
Calf Before You Dig No.�O 1� 3L1 � Approx.time for completion_
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South'Windsor
SEE .f3'h 6 CfI E�) Pavement Cut
No.cuts
0 Est.Size of Perm.Patch(s)
EsL PvL Thickness in.
Est.Unit Price$
Amt.of Deposit
Total Due$ by
{ )Cash{ )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt. Due Town
By
pllcantis res onsible for contactin
the Polumpe Date
2t.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 t AM FAMILIAR WITH AND WILL ASIDE BY THE RULES AND REGULATIONS FOR
PERMITS A OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Sig ed: e, � �.-- Date: —f/r o f
Title:
Driver's License#:
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