HomeMy WebLinkAboutCAble Street Cut Permits Between 18 and Permit No 2606 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD Ems" `CA "--,-I?-EBBIE DRIVE
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A licant � Location
Name COX COMMUNICATIONS '�
ThE,EI � b&26, 73&77 , 108&106
Addr.. 801 PARKER ST. xx �'� s
06040 CT 06040 Typ v WOrk CABLE
Phone (860)512-5000
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Applicant agreed f h , - a dsor the amount of bond
required and to re l mi r?s e 'fio r M�, uth` t lsor 4 for any expenses
incurred by the Tow �oF ep ��wk i n connection with this
permit and that app' `` � � ► i 11 abide by the rules and
regulations for per4jt � � p ",l f South Windsor's Street
Cut Permit Manual . °
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* PERM T T _E XEP T ",4T ALL TIMES
Issued by " 7itle
Date. Completed Inspected By
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
154..0 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Coy ro— 1
Phone No.
Address of Firm AQtce2 S12 -S2c°y ar ,pV�
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Location of proposed work i 0 2 wean 0 126 13
Describe fully nature of permit requested Tou n r,}Js a
Starting date L n7j Approx.time for completion
Call Before You Dig No. 11il 'off - r7YZ Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Pa ee
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: Z�j Dater/ �p
Title: D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc