HomeMy WebLinkAboutCAble Street Cut Permits Between 24 and Permit No. 2538 Town of South Windsor, CT
Date 02/16/1999 Street Excavation Permit
Expiration Date 02/16/2000
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Applicant
j, Location
Name COX COMMUNICATIONS ° � � TFN &36
Addr. 801 PARKERST.
06040 CT 06040
Phone (860)512-5000 TYpQf. W�r CABLE
Applicant agrees `f �hah 5- of '
'07 ► rW��dsor the amount of bond
required and to e uth a 1so � for any expenses
incurred by the Towp fiio'r` a�i � reps yya An connection with this
permit and that appD aa1 � . w T TV abide by the rules and
regulations for 9 perm,iT � T, �"South Windsor's Street
Cut Permit Manual .
* * PERMIT TO ;at K ( T E*hi JbB &TTE,AT ALL TIMES.
Issued by t tyl e
r
Date Completed Inspected By
L as3�s
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firms Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Cali Before You Dig No. O GTj Traffic Services Control No.
Show sketch of proposed work or famish To be filled out by DWI of South indsor W
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No.cuts
Amt.of Deposit$ by
�)Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Town$
Applicant 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: 7. Date:
Title:
D.L.#:
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc