HomeMy WebLinkAboutCAble Street Cut Permits 145 Norton Lane Permit No. 2648 Town of South Windsor , CT.
Date 04/13/1999 Street Excavation Permit.
Expiration Date 04/12/2000
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Applicant Location
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Name COX COMMUNICATIONS R��,"LANE
Add r. 801 PARKER ST. � »t
06040 CT 06040 � e � 1 �`rk ABLE
Phone (860)512-5000 .
Applicant agrees fi`t r �tI W�Of S� #" or the amount of bond
required and to reimt�uek
" ToG�irt ' � h ti " fr any expenses
incurred by the Town fca � Rai1ifi connection with this
permit and that app 1 i�a ,�', ar� � iYl, tide by the rules and
regulations for permsth Windsor's Street
Cut Permit Manual .
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* * PERMIT TO BF, ';KEPTb E B IT " A °'ALL TIMES.
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Issued by "'., ; ._s-4 e
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 $25.00
Name of Firm �® C(6 IQ- Phone No. R60— S-Q _ Sa Lip()
Address of Firm Rol ar er' 7 f5fe
Location of proposed work I A/or `! ' Lk
Describe fully nature of permit requested h e /
Starting date —/ — Approx.time for completion 115
Call Before You Dig Nod Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
INS No.cuts
Amt. of Deposit$ by
O Cash O Check#
• ed 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: - - D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc