HomeMy WebLinkAboutCable Street Cut Permits Between 80 and Permit No. 2574 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND RODS C'A� -MERLE ROAD
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Applicant Location
Name COX COMMUNICATIONS QETu1El' &94 AND 38&44
Add r. 801 PARKER ST.
06040 CT 06040 M a type fmoi� Work CABLE
Phone (860)512-5000
Applicant agrees( �h of �1M1 ndsor the amount of bond
required and to re i rte Tom �� w y e uth so�-i for an expenses
incurred by the Tows ri � ep � vofi� i n connection with this
permit and that app abide by the rules and
regulations for permats `s � r �, � fi p' f South Windsor's Street
Cut Permit Manual .
* * PERMIT Tl E� t "1 �J61 �"�LT
T ALL TIMES.
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Issued byRT itle �
I'
Date . Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm S Phone No. J�2 -;2pU
Address of Firm
Location of proposed work &e/cie eti
Describe fully nature of permit requested
Starting date Approx.time for completion -
Call Before You Dig No. Y Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
P P 9
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
�)Cash O Check#
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:&15P T
Title:— D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
.Standard Forms\Permits\Street Excavation Permit.doc