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HomeMy WebLinkAboutCAble Street Cut Permits Horizon Circle Permit No. 2548 Town of South Windsor, CT Date 02/17/1999 Street Excavation Permit Expiration Date 02/17/2000 Descrip: INSTALL 8' GROUND ROD ., �OR`'C"A7V` w-�,#,ORIZON CIRCLE Applicant Location Name COX COMMUNICATION$z � � ` ` EI z &70 Add r . 801 PARKER ST. r 06040 CT 06040 T yp "i 1rC CABLE Phone (860)512-5000a 'K x Applicant agrees ti3 h � of �v 1 n sor the amount of bond required and to ref Pa eI&W ToyCr uth-� dsorfor any expenses incurred by the Tows rk � �e� rep - I 6rok ' i n connection with this permit and that app i,c rlt 'zs 1 1 ;ar Y,w,Mabide by the rules and 7111 regulations for perrO South Windsor's Street Cut Permit Manual * * PERMIT T© ` K� Jt�B= �TT'E AT ALL TIMES. ? «' Issued by title Date Completed Inspected By 'A' �syg APPLICATION`FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm &, C,P.t. Phone No. Address of Firm Location of proposed work 2or-� r P �co� 2D Describe fully nature of permit requested .G�' Starting date Approx.time for completion Call Before You Dig No. 1*X Traffic Services Control No. - Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut No.cots Amt.of Deposit$ by OCash O Check# Cut size after Perm. Patch No. Cuts Final Billing$ Amt. Due Town$ Applicant is responsible for contacting by,date the Police-be pt.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. s/Signed:' Date: Title: D.L.#: PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street.Excavation Permit.doc