HomeMy WebLinkAboutCAble Street Cut Permits Between 196 and r'
Permit No. 2617 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/1.7/2000
Descrip: INSTALL 8' GROUND ROD FOff `CAT 14�,,FAIRVIEW DR.
Applicant Location
Name COX COMMUNICATIONS ,s �' ,.�� `BTWEI ' a�6&184, 77&71 ,
Add r. 801 PARKER ST.
06040 CT 06040 q Type Qf 4�16 CABLE
Phone (860)512-5000 '' ,
Applicant agrees �i ash-Its �e of" ' t 1Ia i dsor the amount of bond
required and to reiburtle 'fov,�t1 'off �uth' for any expenses
incurred by the Town n � repai ^ iwok;° in connection with this
permit and that appean 43° fim'i 1,. et � id jvi f ? abide by the rules and
regulations for perm Pbv d'1'61 . South Windsor's Street
Cut Permit Manual . 'ti
V
s '
* * PERM I T6,,'� AT ALL TIMES.
Issued by 1�" � � �" �,�:M��r�� 7it1e
Date Completed Inspected By
144
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN_AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm ro k u Phone No. S1z-Sell D
Address of Firm 02J 4a P-s7~
Location of proposed work KATF)i e Z- a " 1.S E 9
Describe fully nature of permit requested5 Doti rI - �tv
Starting date - IS Approx.time for completion 3'IS-f oi -
Cali Before You Dig No.I S�=06Q- 12121 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop:size of cut
No.cuts
Amt.of Deposit$ by
{)Cash{)Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due 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: 2
Title: D.L.*:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc