HomeMy WebLinkAboutCAble Street Cut Permits 62 Quarry Brook 2830 Town or South Windsor, CT
Permit No. Street Excavation Permit
Date 08/20/1999
Expiration Date 08/19/2000
pescrip: QUARRY" BROOK AND SIMC'-A DR - CABLE REPAIR
Applicant Location
Name COX COMMUNICATIONS
Add r. S0l PARKCR S T . Type of Work CABLE
06040 CT 06040
Phone (860)512-5280
Applicant agrees to furnish the Town of South Wndsoratheeamount of bond
required and to reimburse the Town of South Wjndsor
for incurred by the Town for maintenance o'"r repair work in connection with this
permit and that applicant is� almawith the TownwoflSabut�eWbndsoer' suStreetles d
regulations for permits a.soutnecf in
Cut Permit Manual .
* PERMIT TO B3 KEPT ,ON JO8 SITE AT AL .. TIMES . * g
Title _ _ �, _.__-----
Issued by -- - --
`ti ,
Inspected By
Date Completed
_ __ �---
APPLICATION FOR STREET EXCAVATION PERMIT
a�
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm & 4&Lrr e
Address of Firm S Phone No.
Location of proposed work
Describe fully nature of permit requested Q- Qi
Starting date -
Call Before You Dig No._ gq,,laa yg1 Approx.time for completion
Traffic Services Control No.
Show sketch o propo work or famish
two copies of eparate rawing To be filled out b To n of So th Windsor
Indicate Nort Pavement cut
Prop.size of cut
�Ck q— No.cuts
Amt.of Deposit$ by
�s OCash OCheck#
t..0 (]37
Cut size after Perm. Patch
No. Cuts
Final Billing$
PAmt. Due Payee_ -
Amt. Due Town$
Applicant s responsible for contacting
the Police a. . and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WIT
REIMBURSE THE TOWN OF
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED I
TOWN OF SOUTH WINDSOR's STREET CUT PERMIT MANUAL. H THIS
N THE
Signed: s h l 9
Title: Date:
D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc