HomeMy WebLinkAboutStreet Cut Permit 96 Rockledge Drive SOUTH WINDSOR
800119
PEPERMITRMIT TOWN OF NUMBER CT
STREET CUT PERMIT
DATE: 07/16/08 � �< �s �� -`'1•-
GIS ID: 76800096oc
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MUNIS APPLICATION200801077
# 200801077y. }; .• K"'r.. ., FEE: 25.00
ATION DATE: 07/16/09
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APPLICAN
NAME: "K .TELE-NETWORKS LOCAT
ION
ADDRESS: 31 BAKEWELL COuxp- -EDGE DRIVE
CRASTON,RI 02921 ` % f y ' , :.JOIN J&DEBORAH N
l fD DRIVE
PHONE GE
401-461-8420 # " " QiJCIIVDSOR,CT 06074
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WORK DESCRIPTION: 96
-10��
APPLICANT AGREES TO FURNISH THE TO'
^�*
THE TOWN OF SOUTH WINDSOR FOR ANY sPbi � `Bv1J REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT I` C M Rr AIN
4 }' � TENANCE OR REPAIR WORK IN
PERMIT AND THE IsI T iS° H �L ABIDE BY THE RULES AND REGULATIONS
RIfT
FOR PERMITS AS OUTLINED IN THE TOWN OF S
. ,.. � ..FVIITMANUAL.
ISSUED BY
DATE INSPECTED INSPECTED BY
7/1 6/2008 1 1:31AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0'00 J 1 9 CONTRACTOR:_
LOCATION: q& - /o& 12o ck- ff /fie jpQ
TYPE OF WORK: c
DATE INSP NEEDED: DATE INSP: a h116
INSPECTED BY:_ 0
WORK IN /
PROGRESS:
AS-BUILT:
INPUT: C DATE:_ . 10
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMITp
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm TELE•NETWOKKS Phone No, .84;-Z382
Address of Firm 3( KCWCLL CT C N N 1�2 02Q2 I
Location of proposed work 96- f 6( iGOClpr
Describe fully nature of permit requested S T -PLA CA 7V
Starting date o 7`O
Approx. time for completion_ l 94L-/
Cal(Before You Dig No. s Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Sea ATT'ACROD Pavement Cut
No.cuts
Est.'Size of Penn.PatctKs)
Est.Pvt.Thickness in.
Est.Unit Price$
Arnt of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. 'Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contactiqg Datp
the Police Dept.and C.B.Y.D.
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. UTLI ED N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL
Sign Date; 0
Title. Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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