HomeMy WebLinkAboutCAble Street Cut Permits 55 Chase Farm R Permit No. 2747
Town of South Windsor, CT
Date D6/29/1999 99 Street Excavation Permit
Expiration Date 06/28/2000
bescrip: CATV SERVICE
Applicant Location
Name COX COMMUNICATIONSHA ARM ROAD
Addr. 801 PARKER ST. � 4
06040 CT 06040 Cy o-f WCrt SCR CABLE
Phone (860)512-5000
Applicant agrees to fur03ah the T+p o the amount of bond
required and to re i mluseh� :totem c� th Widra. fpr any expenses
incurred by the Town ;for ,�palp��r �- connection with this
permit and that app 1 in°t=,� i de by the rules and
regulations for permits i net n t1e "Ti d Sputh Windsor's Street
Cut Permit Manual . A '
" r
PERMIT T0` Ef^� ()t1 $TTET ,ALL TIMES.
Issued by
Date Compldte 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 - Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date 7 Approx.time for completion J4
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work7of furnish 11 To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit po $ by
{)Cash{)Check#
Cut size after,Perm. Patch
_ w ` No. Cuts
00A&F f Fifrh Kco
Final Billing$
Amt. Due Payee-$
_ 2
SoZ 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 WINDSORIS`STREET CUT PERMIT MANUAL.
Signed: Date: C Q
Title: ,?C o D.L.#•
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
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