HomeMy WebLinkAboutTelephone Street Cut Permits Scott Drive Permit No . 2345 Town of South Windsor , CT
D0,te 08/21 /1997 Street Excavation Permit
Expiration Date 08/21 / 1998
Descrip :
App i i can t Locat i on
Name CABLE ��ONSTRUC`i"ION CO. CvR', COTT & AL_PINE CAR
Addr . 405-D NEW STATE ROA00
MANCHESTER CT 06040 Type of 'Work TELEPHONE
Phone (860i649-8217
Applicant agrees to , fUrnieh, the' Town, of ='South Windsor the amount of bond
required and to re i mbu r sp ,the ;,Town, cof. t,,Outh Wtndepr for any, expenses
incurred by the Town fore mathtenance or �repairwwtirkJ. in' connection with this
permit and that applicant Js famiiiar with. :land, wII' abide by the rules and
regulations for permits gs outlined in the 'T6wn of South Windsor' s Street
Cut Permit. Manual : `
t
PERMIT TO BE KEPT 0,NV J0"B .SITE AT ALL TIMES.
Issued by
Date Comp Ieted 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 �G¢dl� t�c9S> = Phone No.
Address of Firm 41o5- /Ue...fJ
Location of proposed work
Describe fully nature of permit requested
if:G✓Lo s� s"
Starting date &V 261-97: Approx.time for completion
Call before you dig no. 1 7 Y 4/1 RG Traffic Services Control No.
Show sketch of proposed work or furnish To b@ filled out by Town of So. Windsor
two copies of separate drawing ,( _. Pavement Cut
Indicate North Prop.size of cut e.-.Je jgw,
f No.cuts_L_ /
Amt.of Deposit 4�esl!Z by
CashX Check# 5�(S'3 Z.Z.S—.$442
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee$
Amt.Due Town 0
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED ANDTO 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: i l '� < -
Title: �"�- Caw�� D.L.B 1 1 1 e'm
-HERMIT-SHALL BE-KEPT ON J013SITE-AT ALL TIMES
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