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HomeMy WebLinkAboutCAble Street Cut Permits 21 Dawn Drive � s Permit No. 2910 mown of South Windsor, CT Date 01/18/2000 Street Excavation Permit Expiration Date 01 /17/2001 Descrip: Applicant Location Name COX COMMUNICATIONS DAWN- Addr. 801 PARKER ST. LTD21 ' DAWiIVE 06040 CT 06040 Phone (860)512-5280 T�,P . 'cf � " CABLE Applicant agrees iao� f t.t-il is"I"' �'th® Town, of 56utK WI n�dsor the amount of bond required and to re i mb�rre, �uth � r for any expenses incurred by the Town for s" tend c TM epai Work n connection with this permit and that app 1 int � t ,an f 1 I .,;abi de by the rules and regulations .for permits as, , 1 ied� rr � Tcbc�f Cut SSutlt Windsor ' s Street C' Permit Manual . ; xc fP,MIT TO E KtwPT ©N J. B S1 E AT ALL TIMES. *. * Issued by Date Comp1et d _ Inspected 8y I APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm Phone No. Address of Firm Location of proposed work Describe fully nature of permit rey ested is Starting date- Approx.time for completion !7 Call Before You Dig No,0-jd= Q3q-0 -�L t Traffic Services Control No. Show sketch of proposed work or furnish To be.filled out by Town of South Windsor two copies of separate drawing Pavemen--��rt . Indicate North Prop.size of cut No.Cuts a Amt.of Deposit$ by \ {)Cash{)Check# Cut size after Perm.Patch No. Cuts Final Billing$ 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: rr: .a Date: 1 Title: a2a%:,r D.L.#: PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street_0(cavation Permit.doc