HomeMy WebLinkAboutCAble Street Cut Permits 42 Saddleback D Perm-ft No. 2796 `� Town of South Windsor, CT
Date 08/04/1999 Street Excavation Permit
Expiration Date 08/03/2000
Descrip: CABLE SERVICE
Applicant Location
Name COX COMMUNICATIONS 0 43 , SADDLEBACK DRIVE
Addr. 801 PARKER ST.
06040 CT 06040 �.' Type of Work CABLE
Phone (860)512-5280
App1 icant agrees too= fu ryf , ;'the :T jwn, f Sa 1 h WarFdsor the amount of bond
required and to reimbu a `'fo o th ti�1nd or for any expenses
incurred by the Town ,f or _,.11°0, k i n connection with this
permit and that appli:c. t 3, ° fam, t' w�tifi, and -oi1 ) abide by the rules and
regulations for permit .:as autlir d ,1n th Torre of,-South Windsor's Street
Cut Permit Manual .
t.
KEP:T ON JQ6 .SITE AT :ALL,1.S-MES.
Issued by Title
� T
Date Completed Inspected By
d15�
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �� 7`- Cce Phone No.
Address of firm
Location of-Proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion o
Call Before You Dig No. I Ro 13 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North 43 Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
A04&4v944p�
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:-,,,..,,, / l
Date:-
Title° D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Foams\Permits\Street Excavation Permit.doc