HomeMy WebLinkAboutCAble Street Cut Permits 87 Dawn Drive Permit No. 2719 Town of South Windsor, CT
Date 06/21/1999 Street Excavation Permit
Expiration Date 06/20/2000
Descrip: CABLE TV SERVICE
Applicant
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Location
Name COX COMMUNICATIONS
{?aAWI� I V E
Addr.. 801 PARKER ST. rr
06040 CT 06040 � � pfo�-} ;CABLE
Phone (860)512-5000 q
Applicant agrees to th � �� � y door the amount of bond
required and to reimur� th I fpr any expenses
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incurred by the Town forairen " ? p a i a tC i connection with this
permit and that app 1 iarrt:' f2 � �11i de by the rules and
regulations for permit ei net h the '7rrf, Sp`uth Windsor's Street
Cut Permit Manual . ^'
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* * PERMIT TO, ALL TIMES.
Issued by r _ Tiale � w
Date 'Comple ed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
�'1 ( yo FEE $25.00
Name of Firm C_ -U X— C4�° ` Phone No._
Address of Firm
Location of proposed workr{? ,4 1)R
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt.of Deposit$ by
()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 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: co
Title — D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc