HomeMy WebLinkAboutCAble Street Cut Permits 74 Sharon Drive s
Permit No. 1768 Town of South Windsor, CT
Date 07/15/1999 Street Excavation Permit
Expiration Date 07/14/2 00
Descrip: CABLE SERVICE
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Applicant Location
Name COX COMMUNICATION rp74 _ a DRIVE
Addr. 801 PARKER ST
06040 CT 06040 Type "'. fO ` ABLE
Phone (860)512-5000 .>
Applicant agrees t .ft r�. thek T Srpu , sor the amount of bond
required and to re i mb #�, ihe �, th W1pr..; ,r any expenses
incurred by the Town r Aairttena off' pai Work connection with this
permi t and that app 1 i rat ° , fa u x n by the rules and
regulations for perms asa tl end an then '-cif $duth Windsor's Street
Cut Permit Manual .
9
* * RMIT TO`u E 1 CP o ,4T;.£gALL TIMES.
Issued by .�a 'Tatte
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Date Completed Inspected By
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS. DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name'of Firm dx )e Phone No.
Address of Firm >rfl r
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
d o
Show sketch of proposed work or furnish To be filled out by Town Qf S
two copies of separate drawing outh Windsor
P vemerlt ca
s Indicate North Prop.size of cut
No.cuts
6 Amt.of Deposit$ by
O Cash O Check#
Cut size after Penn. Patch
ry ` No. Cuts
® Final Billing$
Amt.Due Payee
ue Town$
Applicant is responsible-for contacting by date
the Police De .and ".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;_
Title:
PERMIT SHALL BE KEPT ON 300SITE AT ALL TIMES
Standard FormsWermitAStreet Excavation Permit.doc