HomeMy WebLinkAboutCAble Street Cut Permits 79 Ridgefield D H
Permit No• 2915 Town of SOUt�'i Windsor,rlc]sor,
Date 01 /24l2000 CT
Street Excavation Permit
Expiratidn Oate 01 /23/2001
Descrip.
Applicant
i_(')c.at.i car)
!Name COX COMMUPN I CA F IONS
Addr . 601 PARKER S.rI �E�O 'DR
06040 C7 06040
Phone (.401 )821- 1 S 1 9 T / e 0 Woj* CABLE
Applicant agrees to fv'r'#7lish' thy, Tows of South Windsor the amount of bond
required and to re 1 mtiUr e .;t �,; Town-a nth Wxrtc sor for any expenses
incurred bu the Town f .ea �, r i"epa i Work in connection with this
permit and that appl ioant' farn ±t� ;. n {x,y�j 1 1.. abide by the rules and
regulations fore; 30 ,�-o ,South Windsor 's Street
Cut Permit Manual .
PERMIT TO 8E KEPTSITE AT "AL! TIMES.
Issues{ by t'ie r�5��"T �K.;C�,
Date Completed Inspected Rv
APPLICATION FOR STREET EXCAVATION
PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $2S.00
Name of Firm C O yL C0rA_r1LL `
Address of Firm O tLoK
Phone No. 'G 0 90
Location of proposed work
Describe fully nature of permit requested N c
Starting date4o. — I
oz7
Call Before You Approx.time for completion o�
raffic services control No.
Show sketch of proposed work or furnish
two copies of separate drawing To befilled
in of South wind r
Indicate North Pave, menu
Prop.size of cut ,
�-7 No.cuts
/ Amt.of DepositQb
$
�' by
-O Cash O Check#
Cut size after Perm. Patch
No. Cuts ,
Final Billing$
Amt. Due Payne.
Amt. Due Town
Applicant is responsible-for contacting
the Police De t.and C.B.Y.D. byr
date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULESQ IRED AND TO REIMBURSE THE TOWN OF
TOWN OF SOUTH WINDSOR`S STREET CUT PERMIT MANUAL. AND REGULATIONS FOR PERMITS S OUTLINED N THE
Signed: a�G4„y
Date• 1 C7
Title: e
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc