HomeMy WebLinkAboutCAble Street Cut Permits Pole 2334 to FN Permit No. 2634 Town of South Windsor, CT
Date 03/12/1999 Street Excavation Permit
Expiration Date 03/11/2000
Descrip: QUARRY BROOK DR. - TREN 'ffi� IN ;re RIGHT OF WAY
Applicant
Location
Name COX COMMUNICATIONS s nor
Addr. 801 PARKER ST. fN. � 334 TO FNB
06040 CT 06040 pe ABLE
Phone (860)512-5000 E
' sa' �.�
Applicant agrees to �U,r9g tr� ci ►� �f Stud y VCaM&ior the amount of bond
required and to re i mb�'r�e ®thy Town � � h�t W r f6r any expenses
incurred by the Town a i�i�t Hai 'ijh connection with this
permit and that app 1 i iatt ari 'ilk
� 1' '` bide by the rules and
regulations for permitsas,ib # o uth Windsor's Street
Cut Permit, Manual .
�i
* * PERMIT TO 13 �,,T�"ALL TIMES.
Issued by
Date Completed Inspected By
4
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �-_dyl
Address of Firm Phone No.
Location of proposed work
Describe fully nature of permit requested
Starting date --�
Call Before You Dig No, 1 O 1 W Gr- APProx.time for completion p
Traffic Services control No.
Fh
work or furnish
awing To be filled out b Town of South Windsor
Pave C
Prop.size of cut
e No. cuts
C 1 , Amt.of Deposit$ b
Y
()Cash ()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting
the Police Dent and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TO
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED TOWN OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. H THIS
IN THE
Signed: r
Date: l
Title:
° D.L.#:
----------------
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
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