HomeMy WebLinkAboutCAble Street Cut Permits 61 Homestead Dr Permit No. 2699 '
Date 05/27/1999 ! Town of South Windsor, CT
Street Excavation Permit
Expiration Date 05/26/200.0
Descrip: CABLE TV
Applicant
r Location
Name COX COMMUNICATIONS ' ° Qg1OMSAD DRIVE
Addr. 60i PARKERST. � �
i ��a
r
06040 CT 06040
o Phone (860 )512-5000 � � �®�� CABLE
Applicant agrees fiyo , r� theiridor the amount of bond
required and to reimburte
� :MT arh Af,:� h W"I i3sbr f6r any expenses
incurred by the Town for TR,4,411
41tenan �" �pa �r ih connection with this
permit and that applicant frfi7 =
regulations for permiis abide by the rules and
ne n
Cut Permit Manual . � � � "16WI ° Squth Windsor ' s Street
* *�PEERRMIT TQ��E'� EpT �: TE ALL TIMES.
Issued by
Date Completed _
Inspected By _
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN Of SOUTH WINDSOR .
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm.(�cx Ue Phone No.
Address of Firm / r e T )-
Location of proposed work G/ lfi"es7`eec( ()-
Describe fully nature of permit requested e
Starting date 6-2-17 Approx.time for completion 100 r, yS
Call Before You Dig No.h99X�o;Z 307 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
Q�e' No. cuts
1�^
Amt.of Deposit$ by
r O Cash O Check#
I
t Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Payee$
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.
Signed2 Date: C/
Title: D.L.#•
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc