HomeMy WebLinkAboutCAble Street Cut Permits Between 25 and (2) Permit No. 2551
Date 02/17/1999 Town of South Windsor, CT
Street Excavation Permi.t
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD p �'
��DGEFIELD DRIVE
Applicant
Location
Name COX COMM UNICATION$
Addr. 801 PARKER ST. ` BTN f5&37 , 79&9i
�'r:� 918�107
06040 CT 06040 z �
Phone (860)512-5000 °� ` "gyp* of bVor CABLE
Applicant agrees
required and to re in r
f �1hP � ` of il,, jo
ndsor the amount of bond
fe To +puth`� .
incurred by the Tows ; J � �r for any expenses
Permit and thatY . repc i n app �n � �. ; connection with this
regulations for perm s � abide by the rules and
Cut Permit Manual . ' °°� ffSouth Windsor's Street
tz
R f
* * PERMIT T ALL TIMES.
Issued by�""r i t 1 e �. g
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 $25.00
Name of Firm / firl�r.dt Phone No. �
Address of Firm
Location of proposed worker Z, e eg„
Describe fully nature of permit requested n
Starting date Approx.time for completion
Cali Before You Dig No. Traffic Services Control No.
FIndicate
ketch of proposed work or famish To: filled out 6 Town of Sou h Windsor
pies of separate drawing
Pavement ut
-North Prop.size of cut
No.cuts
Amt.of Deposit$ by
�)Cash t)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 De t.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 306SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc