HomeMy WebLinkAboutCAble Street Cut Permits 102 Kent Lane Permit No. 2745 Town of South Windsor, CT
Date 06/29/1999 Street Excavation Permit
Expiration Date 06/28/2000
Descrip: CATV SERVICEK
Applicant
Location
Name COX COMMUNICATIONS e N ,NE
Addr. 801 PARKER ST.
06040 CT 06040 6 'CABLE
Phone (860)512-5000
Applicant agrees to`, f4r `ta7�� f �� d*or the amount of bond
1
required and to re i mt e h io, �r any expenses
incurred by the Town n
permit and that applicantRa � � connection with this
' � � � 1ide by the rules and
regulations for permiS sae �1�m Inv � { .Scuth Windsor's Street
Cut Permit Manual . � � ua= ,� �F
* * P RMIT TO BE StTF AT ALL TIMES.
r
Issued by
Te r�
Date Comp l e /
� Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Finny Address of Firm d Phone No.
Location of proposed work D L
Describe fully nature of permit requested 'fV
Starting date o2
Call Before You Dig No." ! f 9 9 7. 1 Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing 1 1 To be tilled out b Town of South Windsor
Indicate North Pavement Cut v
Prop.size of cut
Co� No.cuts
Amt.of Deposit$
by
()Cash{)Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by---------
the Police De t.and C.B.Y.D. date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE T
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 0� IN TOWN OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. LINED IN THE
Signed:
Date:
Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard FormsTermitAStreet Excavation Permit.doc