HomeMy WebLinkAboutCAble Street Cut Permits 44 Simcka Drive P�, rmi !Jo. 2868 Town o-c South Windsor, CT
Date 09/17/1999 ;street Excavation Permit
Expiration Date 09/16/2000
Descrip: CATV REPLACEMENT!
Applicant Location
Name COX COMMUNICATIONS 0044 Simcka Drive
Addr. 801 PARKER ST .06040 CT 06040 Type of Work CABLE
Phone (860 )512-5280
Applicant agrees to furnish 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 applicant` is 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 .
* `.PERMIT TQ- BE KEPT ON JOB SITE AT ALL TIMES,.,
Title
Issued by . ' ---�-- --
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 $2500
Name of Firm X cc�!P Ph fp- 1�
Address of Firm �/ r er 04 � r one No.
Location of proposed work j 1M Fa US-,
Describe fully nature of permit requested
Starting date 99
Call Before You Dig Mo. 3$p / Approx.time for completion_ ISO
Traffic Services Control No.
Fhkeroposed work or furnish To led o t b Town'of South
arate drawing fil v Windsor
Pavement .+Prop.size of cutNo.cuts
_ Amt:of Deposit'$ b_. y
O Cash O Check# \
Cut size after.Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town.:$
Applicant is responsible for contacting b the Police De' and C.B.Y.D. y date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION TOWN-OF,
ITH 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. HE
Signed: C}'
Date:
Title:
D.L.#:
PERMIT SHALL BE KEPT ON 30051TE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc