HomeMy WebLinkAboutCAble Street Cut Permits Between 90 100 Permit No.
Date 2559
02/17/1999 Town of South Windsor, CT
Expiration Date 02/17/2000 Street Excavation Permit
Descrip: INSTALL 8' GROUND ROD , ..
` � CHESHIRE DRIVE
Applicant
Name ATI
Location
MMUNICONS
COX CO b �
Addr. 801 PARKER ST.
f
06 06040
040 CT � E &100 AND 17&25
Phone (860)512-5000
ryp 'c � V rk CABLE
a a �
Applicant �
required a ree � a � ,
and to reiiinn, tsh
incurred b �•k►e Tom indsor the amount of bond.
Y the Town fojr ��� + uth Sod for
Permit and that a . :, d ° ire any expenses
regulations for pp � � � x ' ' p � w�, i n connection with this
Perri as � 1 w. lt4 abide b i s
Cut Permit Manual . ou y the rules and
th Windsor's Street
* * PERMIT
� ... � �TT
Issued by ALL TIMES.
kN
Date Completed tle �i
Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm L (�w/01 Phone No, 5-;2B0
Address of Firm
Location of proposed wo IO Q/E _ /•��2 --
Describe fully nature of permit requested
Starting date Approx.time for completion -
Call Before You Dig No. F9jMO Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out.by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
t)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 De t. nd 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: 2 /ii
Title: D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES'
4 _J.Standard Forms\PermitslSt ftfmyation..PermiLdoc-------