HomeMy WebLinkAboutCAble Street Cut Permits Between 89/103, Permit No. 2605 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD �F ;'C T - �iEASANT WAY
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Applicant w„ � Location
Name COX COMMUNICATIONS 6 ?VEfw-103, 50-60
Add r. 801 PARKER ST.
06040 CT 06040 Type o WbH� CABLE
Phone (860)512-5000
Applicant agrees o fAh of f P 9 �r W�hdsor the amount of bond
required and to reirrburseovn � uth �1or`;for any expenses
incurred by the Towsfo, repw Wa i n connection with this
permit and that app' �kG � l A td,wl 1f abide by the rules and
regulations for permi t `as: ►t�tlr# ° 1ro. t °i�f `South Windsor's Street
Cut Permit Manual . Az
PERMIT* * PERMIT TO Bi= 10EP1 1~a.3C3`t3;5 TTE1eAT ALL TIMES.
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Issued by � 1 `itle
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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 $25.00
Name of Firm �O� C04n rv% Phone No. J 2B
Address of Firm &I .ari[el s
Location of proposed work h e'854-4 kJA� h 5 l d 3 - 0 7 P0
Describe fully nature of permit requested -74St Lq Cjoon�
Starting date Approx.time for completion
Cal -l��1 Before
e e You Di No. l 9 �
Tr
affic
c Servic
es ces Control No.
Show sketch of proposed work or furnish To be filled out:by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
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 MAINTENANgE 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:. -2 �4��
Title•_ D.L.#•
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc ''-