HomeMy WebLinkAboutCAble Street Cut Permits Between 7 and Permit No. 2595 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD `C'i "'%v- xTYVIEW TERRACE
Applicant " Location
Name COX COMMUNICATION
Addr. 801 PARKER ST. � r
06040 CT 06040 �� ��* �' ��� 4 +
�G Yp o r CABLE
Phone (860)5 12-5000 �
Applicant agrees. e h ',�# ofj� � fit tdsor the amount of bond
required and to reiur the �ov 'uth + deo`r P for any expenses
incurred by the Town es iin Tep r spy in connection with this
permit and that app,tar "` '.�.' � N '1 , abide by the rules and
regulations for perrrit w,n.wf�iSouth Windsor's Street
Cut Permit Manual .
/ PERMIT 1§0 �' � �;�e, TET ALL TIMES.
Issued by _ � t"itle
l
Date Completed Inspected By
asps
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDS ORf CT
r-` (' FEE $25.00
Name of Firm 1.�1k l.U�H. 1,.� � ., 7 PhoneS/Z-
Address of Firm of l42(m ST No. 5-2BQ
Location of proposed work ! /eitJ !/ _ ,,Cr-y Vf7 //
Describe fully nature of permit requested o� y,eoJAO Qo0 CR?T
Starting date Approx.time for completion
Call Before You Dig No. -/8 Traffic Services Control No.
Show sketch of proposed work or famish To be fill d out b Town of South Windsor
two copies of separate drawing
Pave— m—ent Cut
Indicate North
Prop.size of cut
No.cuts
Amt.of Deposit$ by
�)Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting b the Police y t.and C.B.Y.D. date
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:_
Title:
D.L.#:
PERMIT SHALL BE KEPT ON]oBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc