HomeMy WebLinkAboutCAble Street Cut Permits 140 Rockledge D (2) Permit No. 2704 Town of South Windsor, CT
Date 06/01/1999 Street Excavation Permit
Expiration Date 05/31 /2000
Descrip.
Applicant Location
Name COX COMMUNICATIONS X
ROC �JGE DRIVE
Addr.. 801 PARKER ST. ;
06040 CT 06040 6� ABLE
Phone (860)512-5000 .rg MAI-
wry, r3. .4
Applicant agrees to r a i 'thp T� � i �i gWu�d ,or the amount of bond
required and to reimtu e � fow r ��th 4401
r any expenses
incurred by the Town "For �enr ,rd�pai y ti connection with this
Permit and that applicant n ! Sri 1 :ai de by the rules and
regulations for permi t ,as n ;,hwi f . 'uth Windsor 's Street
Cut Permit Manual .
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* * PERMIT TO F, `� �ALL TIMES.
Issued by R
Date `Completed Inspected By
f
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLICS WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $2500
Name of Firm Phone No. 0`�"
Address of Firm 1 ;PA AK 'ST
Location of proposed work (qo RocF<I P-doze DR
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. q 9 �r�C —Traffic Services Control No.
Show sketch of proposed work or furnish To be fiited out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
yo
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
Om No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for'contacting by date
the Police Dept.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 WINDSORIS STREET CUT PERMIT MANUAL.
Signed:
Date: _
Title, t — D.L.#• `
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc