HomeMy WebLinkAboutCAble Street Cut Permits 240 Orchard Hil Permit No. 2911 Town of South Windsor, CT
Date 01/18/2000 Street Excavation Permit
Expiration Date 01 /17/2001
Descrip
Applicant
Location
Name COX COMMUNICATIONS .p1CMARC HILL DRI
Addr. 801 PARKER ST. ; _�
06040 CT 06040 Tj pe of .�lor,, CABLE
Phone (860)512-5280
Applicant agreesu. `t Ton , the amount of bond
required and to reimbu� a ,& oUth W`6d§ar far any expenses
o o� r'�pair rincurred by the Town f k in connection with this
permit and that applicant J�sfa �dr;,W and Will` abide by the rules and
regulations for permits'�as b rtl in6d i`i the ToWn,:of- South Windsor's Street
Cut Permit Manual .
s
* * fb� ERMIT TO CAE KEPT`; SITE AT ALL TIMES .
Issued by 14
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Date Compl�ted Inspected By
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
^SOUTH WINDSOR, CT
FEE $25.00
Name of Firm c Pone No.
Address of firm D
Location of proposed work 0
Describe fully nature of permit requested ti v
rs
Starting date / Approx.time for completion / O
Call Before You Dig NOf D R Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit-$ : by
()Cash()Check#
Cut size after Penn. Patch
No. Cuts
Final Billing$
_. Amt.Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept. and C.S.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: �O
Title• 6wv S r Tl��—6,- D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc