HomeMy WebLinkAboutDriveway Street Cut Permits 89 Saddlebac Permit No. 2591 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD '° �=4kADDLEBACK DR
y
Applicant Location
Name COX COMMUNICATIONS B MIF- .j &81
Addr. 801 PARKER ST.
06040 CT 06040 ` � ypt pf W64 CABLE
Phone (860)512-5000
r f
Applicant a reel
9 i h Te i , of , hdsor the amount of bond
required and to rei nt e To t cs mouth sor-.Jor any expenses
incurred by the TowM o ikep r^ W6rll� in connection with this
permit and that appli"Ra �s °°7 ��� 1i°�1 abide by the rules and
regulations for perr&llt4d 4` ISouth Windsor's Street
r a
Cut Permit Manual . r
PERMIT T( t � T*,� T ALL}TIMES y
.Issued by � � �` . 'itle
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Cox, co"--^• Phone No. 51 z,
Address of firm 637 Pn&retifT
Location of proposed work 50 ee 'l 3S87
Describe fully nature of permit requesEed �` 2
Starting date Approx.time for completion -
Call Before You Dig No.IM — 66 a —&RD Trafflc Services Control No..
Show sketch of proposed work or furnish To b6 filled out by Town of South Windsor
two copies of separate drawing -
Pavement Cut -
Indicate North Prop.size of cut
No
.cuts
Amt.of Deposit$ by
{)Cash{)Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
tie kyee
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.
/ 9
Signed: Date• ���C /
Title: 42'dD.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\$bvetExcavation Permit.doc