HomeMy WebLinkAboutCAble Street Cut Permits Rimfield and Ca Permit No. 2613 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD, FOFt` M F I E L D DRIVE
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Applicant Location
Name COX COMMUNICATIONS ` � � � do, IMFIELD & CARSON WAY
Addr. 801 PARKER ST.
06040 CT 06040
yp o Nbr CABLE
Phone (860)512-5000
Applicant a reed '�
9 � �^ � h of J dsor the amount of bond
required and to rei me r die Iov t1 �ny Muth d o.� a for any expenses
incurred by the Tows .:'� � `, Oil
� ep � a wo4cl i n connection with this
permit and that app`t 1 abide by the rules and
regulations for perma is 'PoirrtFt South Windsor's Street
Cut Permit Manual .
4 y+a
Iq� AT ALL TIMES.
Issued by, 'Title
Date Completed Inspected By
alp i3
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Address of Firm Was Phone No. S v
Location of proposed work Co a W
Describe fully nature of permit requested' ' d
G4=..
Starting date. Approx.time for completion
Call Before You Dig No./ P60 _ ZE y Traffic Services Control No.
Shaw sketch of proposed work or furnish T fil ed o b Town of Sou h
two copies of separate drawing _o I . y * Windsor
Indicate North Pavement Cut
Prop.size of cut
No.cuts
Amt.of Deposit
O Cash()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
- Amt. Due Town
Applicant is responsible for co H
ntacting
the Police De t.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 TH
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH N S
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: Z//,-,LrC-
Title:
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard ForinAPermitAStreet Excavation Permit.doc