HomeMy WebLinkAboutCAble Street Cut Permits 24 Bissell Cour 1;
laerrnit No. 2707 Town of South Windsor, CT
Date 06/03/1999 Street Excavation Permit
Expiration Date 06/02/2000
Descrip: CATV
Applicant Location
Name COX COMMUNICATIONS Q24-�BISSE.:L COURT
Addr. 801 PARKER ST.
06040 CT 06040 ?"yp .Cif 'is'rk 'CABLE
Phone (860)512-5000 . . .
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Applicant agrees to� ~th.°"'tha `f�r �f r�tV�rador the amount of bond
required and to reambu�^se fae To .: ap th V <� �pr fpr any expenses
incurred by the Town for a tena� Qr ' pair k in connection with this
permit and that app 1 a 6 nt ti es f r in Of, 1 l i de by the rules and
regulations for permits gas°; q inedr �n tF e ,, w p South Windsor' s Street
Cut Permit Manual . t
* * PERMIT TO` " KE �` �5`*t:,'ALL TIMES.
Issued by
iDate 'Completed Inspected By
a_70
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
Name of Firm COX C4 SCQ
Phone No.
Address of Firm O/ ZZrPer STNow4es r
Location of proposed work ;;�y rss e-J C 7—
Describe fully nature of permit requested CjTTV
Starting date Approx.time for completion
Call Before You big No.1599a30/6 1/9 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
�q
✓� +r Amt. of Deposit$ by
i
()Cash ()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: 3
Title: D.L.#: 4?
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc