HomeMy WebLinkAboutCAble Street Cut Permits Between 11 and ' by
Permit No. 2573 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD + CA°T --- ,ROSEMARY LANE
Applicant ° Location
Name COX COMMUNICATIONS, r 8E1` Elwk&28, 87&97 , 173&174
Addr.. 801 PARKER ST.
06040 CT 06040 ter. "ryp "" ^ r^k CABLE
Phone (860)512-5000
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Applicant agreed h .� of dsor the amount of bond
required and to rear ��e Ilnuth'; ='lin
for any expenses
incurred by the Tow .r� M4-rep connection with this
permit and� that app i .^ °. �'1 abide by the rules and
_ regulations for perrri fSouth Windsor's Street
Cut Permit Manual .
* * PERMIT T 'KE 1 ^S1TE ,,AT ALL TIMES.
Issued by .Title
Date Completed Inspected By
Y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone flo.
Address of Firm S
Location of proposed work e �s� L7e= Y
Describe fully nature of permit requested '
i Starting date Approx.time for completion
Call Before You Dig No. D -/8 Traffic Services Control No.
` 9 9 060 `!
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
-Arrfit:-Dua Rayee$-
Amt. Due Town$
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 WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: z7
Title: D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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