HomeMy WebLinkAboutCAble Street Cut Permits 20 Bayberry Tra Permit No. 2$32
Town of South Windsor, CT
Date 08/20/1999 Street Excavation Permit
Expiration Date 08/19/2000
Descrip: CATV REPLACEMENT
Applicant Location
Name COX COMMUNICATIONS 0020 .SYBLtRY TRAIL
Addr. 801 PARKER ST.
06040 CT 06040 Type ,. WorC CABLE
Phone (860)512-5280
Applicant agrees t furnj tthc r ►wn Sb ttr Wth'dtor the amount of bond
required and to reimburse t `for th ' in $or for any expenses
incurred by the Town i;or a--j nan e 'Kc�r ,eepai' k ,in connection with this
permit and that app l icah,t i ` f and,",`wai"1 i abide by the rules and
regulations for permits;: s cif, South Windsor' s Street
Cut Permit Manual .
*� * ERMIT TQ ;: KEPI° € Nf ,JOl 'S, TEA l TIMES.
Issued by Ti
tie
Date Completid ) _ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH.WINDSOR, CT
FEE $25.00
Name of Firm Cox Phone No. 1?4CO" SIB—Sa80
Address of Firm of TA r Ker S a 1s
Location of proposed workQO gy rry 7'vg -
Describe fully nature of permit requested CAZV WW—T4-C-4e0""C-,?T
Starting date 2S 9 Approx.time for completion
Call Before You Dig No.0r9913 W2 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
mefer Amt.of Deposit$ by
O Cash O Check#
i
i — — Cut size after Perm. Patch
o 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• D.L.#•
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc