HomeMy WebLinkAboutCAble Street Cut Permits 16 and 24, 70 a Permit No. 2607 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD, FAV' SSICA DRIVE
Applicant
Location
Name COX COMM UN I CAT ION 5 "
� T�1 �24, 70&84
Addr. 801 PARKER ST
06040 CT 06040Work CABLE
Phone (860)512-5000 „F7 nr k�
Applicant agree h of
9 6dsor the amount of bond
required and to reign t ie o uth
r� for any expenses
incurred by the Towp,, g.rep " i n connection with this
permit and that appli
1 abide by the rules and
regulations for perm South Windsor's Street
Cut Permit Manual . ~'
* * PERMIT T ���� I"` B r w&IT �A T ALL TIMES
Rk w i M .
Issued by
e
Date Completed Inspected By
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APPLICATION FPR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, .
FEE $25.00
Name of Firm W k
QO Address of Firm vi .wt w -rf Phone No.
Location of proposed work lezio Qoae !b TW, *7 of 6)v
Describe fully nature of permit requested y f a ' . bull 2
Starting date 2' Approx..time for completion
Call Before You Dig No. ! d- Y3 _Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North t Prop.size of cut
Na.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due flown$
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:-
Title: 42
D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard_Forms\Permits\Street Excavation Permit.doe