HomeMy WebLinkAboutCAble Street Cut Permits Rockledge Drive Permit No. 2579 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip; INSTALL 8' GROUND ROD ,,OR, CATV OCKLEDGE DRIVE
Applicant Location
Name COX COMMUNICATIONSr 7(} LF QE, HOUSE 20, BETWEEN
Addr. 801 PARKER ST. -
06040 CT 06040 °
Phone (860)512-5000 ' ;
yP o 4 5r CABLE
6
Applicant agrees �!1h ofGh rdsor the amount of bond
required and to reinr �x � �
s e 'ory , ,uth� §err afor an expenses
incurred by the Tows- 'r` M
y p
� a, ep W f i n connection with this
permit and that app1 wif"1 abide by the rules and
regulations for pernil' ik e, South Windsor's Street
s
Cut Permit Manual .
K rf.
* * PERMIT &ttt AT ALL TIMES.
Issued by ' it1e
Date Completed Inspected By
f
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT .
.FEE. $25.00
Name Firm Phone No.Address of Firm
Location of proposed work
e��• 7� ///9�OJ
Describe fully nature of permit requested„
Starting date
Call Before You Dig No.1 999 wd Approx.time for completion
Traffic services Control No.
FS1ketch of proposed work or famishTo be filled out b Town of South'Windsor
ies of separate drawing
Indicate North Pavemen Cut
Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by
the Police De t.and C.B.Y.D. date
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:
-Dater An
Title:
D.L.#•
PERMIT SHALL.BE KEPT ON 306SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Pennit.doc