HomeMy WebLinkAboutCAble Street Cut Permits 38 Fitch Meadow ` TOWN OF SOUTH WINDSOR INSPECTION REPORT er
Permit No.
5 , <. Contractor COX COMMUNICATIONS
Location
Type Work CABLE r Address 801 PARKER ST.
MANCHESTER,CT
06040 CT 06040
Phone No. (860)432-5211
Date Insp Needed
Date,I hr p
s 4/ O a 2-
,.
Time Insp Needed
Time In�p°.
Inspected By
Work in Progress
1pput , Date
Permat, No. 3142 Town of South Windsor, CT
Street Excavation Permit
Expiration Data 07/03/2002
Descrip:
Applicant Location
Name COX COMMUNICATIONS a038 ''FIT�H. MEADOW LAN
Addr. 8Q1 PARKER ST.
06040 CT 06040 -,Type oi` WQ�k .CABLE
Phone (8fi0)432-5211
Applicant agrees to furriish� �,h� �'awti �'+�f a�uth° Windsor the amount of bond required and to reimburse the °Town of South Windsor for any expenses
incurred by the Town for �ia, ht�nani�e nor_ ,�^epair. wc�r*k ' °�n connection with this permit and that applicant is; �'am� li�r ���t� and' w�� 1 . �bide by the rules and regulations for permits �s ciu`tiTnad" ;in '�k�e Town of South Windsor's Street Cut Permit Manual .
* .*.PERMIT T{Q -8E KEPT �! .JQa , STTE AT ,ALt TIMES.
Issued by ,..J. �IJA
Date Completed O� 0 02— _ Inspected By %
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR -
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm COX CMAI-A CWM073Phone No.17(00 —S 12 - fS 21,70
Address of Firm po �.t
Location of proposed work --1 9 'r Gk rt �,►�
Describe fully nature of permit requested �G Li E
Starting date :I—la-&-C Approx.time for completion I—S 06.1 K
Call Before You Dig No. 'AA.-;J I X20U K i Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cu
Indicate North Prop. size of cut
No. aits
� Amt. of Deposit$ by
4— ( )Cash( )Check#
�i 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:
Title: lAIA "A D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
Mass: Ph: 888-344-7233
Mass ID#17930 Fax 781-721-0047 ^O O �� 7,0D
DIG SAFE NUMBER LJ
Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON 7ho AT 7:00 AM
Contractor#1167
Date /01 EMAIL CITY Sy l�
STREET ADDRESS I= 41J
CROSS STREET kW y ,
CHANGE IF DIFFERENT: WORK: Installing CATV DEPTH: 24" AREA PREMARKED ?: YES
Utilites Notified: lan. j-L LL tP CrLu,&f T®��;r1 �f cs,'/1C�S(3QneD
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