HomeMy WebLinkAboutCAble Street Cut Permits Between 158 and Permit No. 2549 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descri p: INSTALL 4' GROUND ROD F, A`f�" ��rKRAWSKI DRIVE
Applicant Location
Name COX COMMUNICATIONS;
Addr.. 801 PARKER ST. fEE 58 166 145&153
06040 CT 06040
Phone (860)512-5000 Yp WorkCABLE
Applicant agreedR.
tO , ' h��' of idsor the amount of bond
requi red and to rei .urs e Towne„South „ � or for an ex enses
incurred by the Towh � y p
epervck� in connection with this
permit and that app Marls� 1;' abide by the rules and
regulations for "` � ��' � 'perrri�� s �� r�pl �y , ' xf ;South Windsor's Street
Cut Permit Manual . :
* * PERM TO Bi `OP 04 46161 T*E„ AT ALL TIMES.
Issued by T`itie
Date Completed Inspected By
T
o7h H�1
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No.
Address of Firm �d
Location of proposed work
Describe fully nature of permit requested �,
Starting date Approx.time for completion
Call Before You Dig No./ 94 / /7� -
--�-.--.����Traffic Services Control No,
Show sketch of proposed work or furnish To be ft led out b Tow of South Windsor
two copies of separate drawing
Pavemen Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
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: Dater/9 9
Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard FormAPermitAStredExcavation Permit.doc