HomeMy WebLinkAboutCAble Street Cut Permits 35 Cambridge Dr Permit No. 2906
Date 01/18/2000 Town of South Windsor, CT
Expiration Date 01 /17/2001 Street Excavation Permit
Descrip;
Applicant
Location
Name COX COMMUNICATIONS `
Addr. 801 PARKER ST. 0�3fi° �CAMSR:1DGE DRIVE
06040 CT Ofi040 'SPof Work CABLE
Phone (860 )512-5280 x,
Applicant agrees to u� the .Town of got ,'y�i q�d5or the amount of
required and to re i mbur���r� ';6 .T iW�rit�e�r , fpr any expenses bond
incurred by the Town forttenace: aepait^permit and that a lrycrrt :` fatrtlatar w� tYi. .and ,� abideWdr 'in nbycthenrules a with nd
regulations for permii; j '1 ine ;.'n , the ,Towr�..w , South Windsor 's Street
Cut Permit Manua) .
PERMIT TO 5E'` KEPT` ON JQP SITE ' AT "ALL TIMES.
i !
Issued by '
"' 'Inspected
� - Title
Date Compl7- e � J Ins ecte
� .—__-_- p d By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL,
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
Name of Firm -Phnnp No.
Address of Firm D i
Location of proposed work
Describe fully n re of`permit request N
Starting date 4z IVAInApprox.time for completion /?
Call Before You Dig No. 4 3 O E73 Traffic Services Control No.
Show sketch of proposed work or furnish to ft filled out bit.Town of South Windsor
two copies of separate drawing
EMmerit Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check
rS� w
Cut size after Perm. Patch
r No. Cuts
U .
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: `� G►Z�
Title: S !i/S Y\ D.L.#
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms.�P_ermits\Street.Excauation-Rermit:doc - -