HomeMy WebLinkAboutCAble Street Cut Permits Between 30 and Permit No. 2583 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD_FOR VON SHIRE DRIVE
Applicant
v , Location
Name COX COMMUNICATION
Addr. 801 PARKER ST 48TWEEW 6&38, 60&72
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06040 CT 06040 �
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Phone (860)512-5000 Yp Work CABLE
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Applicant ag ree f1tt� h � `� of
required and to reimbursed„ x °j dsor the amount of bond
incurred by the TowMor a ' ova d �h .� O� for any expenses
il
p � i n connection with this
Permit and that app
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regulations for pe sw, abide by they rules and
Cut Permit Manual . � � 171,E ' South Windsor s Street
* * PERMIT TQ JnB BITE<AT ALL TIMES.
Issued by
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Title zr
Date Completed Inspected By
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE"$25.00
Name of Firm Orf' s .�lv1iC��z) Phone No. "'fo- S k�CJ
Address of Firm
Location of proposed work gl-'7� '
Describe fully nature of permit requested Z.::
Starting date Approx.time for completion -
Call Before You Dig No. l Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
.No.cuts
Amt.of Deposit$ by_
{)Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Town
Applicant Wresponsibie 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.
01
Signed: Date: Z
Title: D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard ForrMS\Permits\Street Excavation.Permit.doc