HomeMy WebLinkAboutCAble Street Cut Permits Kupchunos Drive Permit No. 2536 Town of South Windsor, CT
Date 02/16/1999 Street Excavation Permit
Expiration Date 02/16/2000
Descrip: INSTALL 8' GROUND ROD t QATV , " VPCHUNOS DRIVE
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Applicant „ , Location
Name COX COMMUNICATION a, '
. .�� dOR
NDY HILL DR.
Addr. 801 PARKER ST
06040 CT 06040 Ail
v , TYp Qi Wr CABLE
Phone (860)512-5000
Applicant agrees h � of lydsor the amount of bond
required and to ret�nbur� `e To i p uth iso.r for any expenses
incurred by the Tows o i C *� rep0,ui , c3 in connection with this
permit and that abide by the rules and
regulations for pernti is �� + Tin tf,Wr'South Windsor's Street
Cut Permit Manual .
* PERMIT T ;
* �'K �" � 'rkT1E, AT ALL TIMES.
1
Issued by `Cit1e " �r
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR CT
FEE $25.00
Name of Firm 4 fi � ,�, Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested Zo ( ,v
Starting date Approx.time for completion
Call Before You Dig No. IP 70608 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ -by
O Cash O Check
Cut size after Perm. Patch
No. Cuts
Final Billing$
Arnf. Due-Payee
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 WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: ��ll
Title: D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
— 'S ncn and orms\Permifs\ treef xcavation Perris t.doc