HomeMy WebLinkAboutCAble Street Cut Permits 141 Fairview Dr DarmIt. No. -
'982
06/19/2000
Exp Town of South Windsor, CT
>i ration Date Og Street
Desrip. REPLACE /1 �12001 Excavation Permit
LINE FROM 141 TO 173 F
ApUI �i�:dnt
AIRVIEW_ BORE UNDER MARA TRAIL.
Name COX COMMUNICATIONS
Addr. 801 PARER ST. Location
06040 CT O6040 014a FAIRVIEW DRIVE
Phone (401 )821-191
9 Type of ,Wori< CABLE
Applicant
required agrees to furn�ch
and to reimburse tha Town of South
incurred by the Town for 'the Town of Windsor the amount
Permit malntenanee �Outt� Winndsor, for of bond
and that for
i s ot` re q any expenses
regulations forepair work in
Cut permits as outlined familiar with connection with this
Permit and will' abide by the rules
Manual . 'the Town of
South Windsor' and
s Street
PERMITO BE KEPT
Issued by -{7N JQ8 SITE q7 ALL TIMES.
Date Comp let�d �_. .. Title
`Inspected By `<y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN-OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,
FEE $ �"
Name of Firm )O erAnA0t FG L Phone No.
Address of Firm 4"Lb Lnt' PIL -
Location of proposed work--I(4 1-I'V-'k CAkac.I
Describe fully nature of permit requested —
Starting date Z ZOO 0 Approx.time for completion
Call Before You Dig No Traffic Services Control No. "
Show sketch of proposed work or furnish To in fi11 d iut b Town f 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$
-A7fti.-f711i5"N-yEe$
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 TFIIS
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
M-%s: Ph: 888-344-7233 DIG SAFE
Mass ID#17930 Fax 781-721-0047
DIG SAFE NUMBER 2000;(,�;-o 3 q a�
Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON AT 7:00 AM
Contractor#1167
Date 00 EMAIL MUNICIPALITY
STREET ADDRESS & DESCRIPTION
(Apartments&Condo's must list name of complex-Or list the q / [�number of feet from the cross st as/well as N,E,S/or W) j tr l ` 7 3 Fa i r-t, ems/ Jr.
CROSS STREET Variq 7
NATURE OF WORK Installing CAN Depth of Work 4" AREA MARKED ? YES
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