HomeMy WebLinkAboutCAble Street Cut Permits 83 Homestead Dr Permit No. 2776 r'
Date 07/28/199g Town of South Windsor, CT
Street Excavation Permit
Expiration Date 07/25/2000
Descrip: CABLE SERVICE
Applicant
Location
Name COX COMMUNICATIONSa(�BS. hpMETEAp DRIVE
Addr. 801 PARKER ST. .
06040 CT 06040 Type. of Wor;k CABLE
Phone (860)512-5000
Applicant agrees to furnish " th'e' Tmwr1 :�Vi°nd"sor the amount of bond
required and to reimbuis� � ; or � ;' cuthrdsor for an
incurred by the Town for y expenses
aL�rtenance a� Yepai. -work in connection with this
permit and that applio t ta fa and 1-11,, abide by the rules and
regulations for permits as mutfd Toxin of 8auth Windsor's Street
Cut Permit Manual .
* PE MIT 7 B KP'f. 4N ° TTE A"LL TIMES.
Issued by
by .�� TYi"t 1 e
Date Complete
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 $25.00
Name of Firm—e4,41 Tom`p Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested C4 e
Starting date Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
as
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O 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 WINDSORS STREET CUT PERMIT MANUAL.
Signed: Date:—
Title: D.L.#•
PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES'
Standard Forms\Permits\Street Excavation Permit.doc