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HomeMy WebLinkAboutCAble Street Cut Permits 245 Niederwerfe Permit No. 2905 Date 01/18/2000 Sown of South Windsor, CT Expiration Date 01/17/2001 Street Excavation Permit Descrip: Applicant Location Name COX COMMUNICATIONS � � Addr. 801 PARKER ST. 4'245IEDE4VERPER ROA 06040 CT 06040 v ; Phone {86p)512-5280 of. I0' 'CABLE Applicant agrees iro required and to reimkufse 1x e T G uth . t-h��rndsor the amount of bond incurred by the Town 'forira� ten = or any expenses Permit and that app 1 i carp fant�,�r ya t panel wfll.1 .ab i connection on with th i s regulations for permi y e rues and Cut Permit Manual . thexT ± rb ;Suth Windsor 's Street * �+ ` PRMIT Ti D Ki~J✓T � :CJ BT�T A"T 'ALL TIMES. Issued by _ Date Comp 1 e�ted ` - --- Inspected By APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 'FEE $25.00 Name of Firm C15�/V�_, Pho a No. Address of Firm Location of proposed work Describe fully nature of it requested Starting date ZI / Approx.time for completion Call Before You Dig o. © Ca Traffic Services Control No. Show sketch of proposed work or furnish To be Ned ut by Town o�f O ith Windsor two copies of separate drawing - Pavements Indicate North Prop.size of cut No.cuts . _ Amt.of Deposit$ by I , l {)Cash()Check# i Cut size after Perm. Patch No. Cuts Final Billing$ Amt.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: Title Ch4zt� yl�,�i� D.L.#• PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc