HomeMy WebLinkAboutCAble Street Cut Permits Rimfield Drive Permit No. 2612 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD,a,FJ W"C"A" " =-- IMFIELD DRIVE
r
Applicant
Location
Name COX COMMUNICATIONS ;
Addr. 801 PARKER ST.
CAR RHEATHER IN FRONT OF
06040 CT 06040
Phone (860)512-5000
Ype o Vr CABLE
Applicant agrees ft,9 rh th the of ,i�h "Windsor the amount of bond
required and to reiaur1" tkie oy" r puthIadsor :`for any expenses
incurred by the Tow�,, br,:palnte
nf repi*. connection with this
permit and that app1, paht"" # w l abide by the rules and
regulations for perrli,ltt j. t � � .0,fvSouth Windsor's Street
. Cut Permit Manual
a as
* * PERMIT b B ' KEG .. y84T �IT ALL TIMES.
Issued by 'Title —
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATIONa� a
PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH. WINDSOR, CT
FEE $25.00
Name of Firm
Address of Firm R D_S Phone No.-V.?,
Location of proposed work t ie! -
tiu Q �
t requestedrm
c
Desribe fully nature of Permit
_
starting date
Call Before You Dig No.14S5�bp l7s Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing To be filled out Town of So th Windsor
Indicate North amme—at Cut
Prop.size of cut
No.cuts
Amt.of Deposit$ b
Y
OCash OCheck#
Cut size after Perm. Patch
No. Cuts
Final Billing$
-Amt, Due Payee$.
Amt. Due Town$
Applicant is responsible for contacting
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
SOUTH WINDSOR FOR ANY p(PENSFS INCURRED BY THE TOWN FOR MAINTENANCE O
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ggIDE BY THE RULES AND R REQUIRED AND TO REIMBURSE THE T OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. R REPAIR WORK IN CONNECTION WITH THIS
REGULATIONS FOR PERMITS AS.OUTLINED IN THE
Signed:c
Title:
Date:
D.L.#:
PERMIT SHALL BE KEPT ON 3018SITE AT ALL TIMES
Standard FormsNPermits\Street Excavation Permit:doc