HomeMy WebLinkAboutCAble Street Cut Permits Between 65 and r ti
Permit No. 2563 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD ,FOR ',TV--JAIL RUN
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Applicant Location
Name COX COMMUNI CAT ION � "� � ' a.,
w ,
E`fE � �S&75
Addr. 801 PARKER ST. � � , � ,
06040 CT 06040
Phone (860)512-5000
� YP C lr CABLE
Applicant agrees f �` '
� h the amount of bond
required and to reiml r~sOke towhi , uth 46�jfor any expenses
incurred by the Town for n �; ;�r� repay f i n connection with this
permit and that app lr� , T � , � ,w ��1�' abide by the rules and
regulations for perm ` t �I ;South Windsor's Street
Cut Permit Manual .
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* * PERMIT T6�
TE T ALL TIMES.
Issued by itle
Date Completed Inspected By
o1J��
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR CT
17 FEE $25.00
Name of Firm Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. 7 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of! Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop,size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final'Billing$
Amt. Due 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 JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc