HomeMy WebLinkAboutCAble Street Cut Permits 99 Quarry Brook -Perm t No. 2795 Town of South Windsor, CT
Date 08/04/1999 Street Excavation Permit
Expiration Date 08/03/2000
Descrip: CABLE SERVICE
Applicant Location
Name COX COMMUNICATIONS 0099 'QUARRY BROOK DRI
Addr. 801 PARKER ST.
06040CT 06040 Tyke a Wi rk CABLE
Phone (860)512-5280
Applicant agrees to.,fur�a.'i sh:the "arr ,, f, Scat .W7 n,clsor the amount of bond
required and to reimburse t Town of: Seiuth Wiiidsor for any expenses
incurred by the Town ffl'r connection with this
permit and that app 1 7 can � � f ami Ifa r 41 th and; wi l 'abide by the rules and
regulations for permits ass t t°tilr ed .i n the .Town of South Windsor' s Street
Cut Permit Manual .
* ERMIT T gE° ,ktT. t : 08IT °AT ALL TIMES. *
Issued by TIt1'e
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 $25.00
Name of Firm CW,(Q Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Calf Before You Dig No. Traffic Services Control No.
d a
Show sketch of proposed work or famish To be filled out by Town of South Wi
two copies of separate drawing ndsor
Pave
Indipte North �q Prop.size of cut
1
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
e,J No. Cuts
"l Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by
the Police Dept.and C.B.Y.D. dateL.
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 WINDSORIS STREET CUT PERMIT MANUAL.
Signed: l
Date: L
Title: —
D.L.#•
PERMIT SHALL BE.KEPT ON JOBSITE AT ALL TIMES
Standard Farms\Permits\Street Excavation Permit.doc