HomeMy WebLinkAboutCAble Street Cut Permits 71 Quarry Brook Permit No. 2773 Town of South Windsor, CT
Date 07/20/1999 Street Excavation Permit
Expiration Date 07/19/2000
Descrip: CABLE SERVICE
Applicant Location
Name COX COMMUNICATIONS 001 QUARRY BROOK DRI
Addr. 801 PARKER ST.
Y, Of
06040 CT 06040 T . : W��'' ,CABLE
Phone (860)512-5000 -
Applicant agrees tm fu►�r�ish ,the Tt�wn - South 'Windsor the amount of bond
required and to reimburse , Town ,off �iuth windsQr fbr any expenses
incurred by the Town ;fir r1 14tenahic* ar t7,epa i r,' k'- n connection with this
permit and that appli,c ►t "s # w th, and well abide by the rules and
regulations for permits; al' �.., ...t ;oW ;gf South Windsor's Street
Cut Permit Manual .
ERMIT 7 BE K l?T #:: Jai,: SATE qT ALL TIMES.
Issued by � T,itl,e '2t; Y
Date Comple ed � � Inspected By
APPLICATION FOR STREET EXC a773
AVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1.540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
// FEE $25.00
Name.of Firm a( G b
Address of Firm r >` Phone No. S/off, S
Location of proposed work �� h
h
Describe fully nature of permit requested
Starting date 7 a3 9
Call Before You Dig No.IW93610 Soo Approx.time for completion S
Traffic Services Control No.
Show sketch s proposed work or furnish To a filled out b Town of South
two copies of separate drawing —h Windsor
Indicate North Pave�ut
J Prop. size of cut
7/ No.cuts
Amt.of Deposit$ by
i
i OCash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting b the Police De t.and C.B.Y.D. y date
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: — y 9
Date:
Title:
D.L.#:
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc