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HomeMy WebLinkAboutCAble Street Cut Permits 15 Skyline Driv Permit No. 2791 Date 08/04/1999 Town of South Windsor, CT Street Excavation Permit Expiration Date 08/03/2000 Descrip.: CABLE SERVICE Applicant Location Name COX COMMUNICATIONS Addr. 801 PARKER ST. OQ SKYLI-NE DRIVE 06040 CT 06040 Phone (860)512-5280 yp .. o Work CABLE ,� Applicant agrees to.- furhi -the �vn,Tpf south. : indsor the amount of bond required and to reimbunse. t Tows �of Wjmdsor .for any expenses incurred by the Town ,f a i enance, ©t repair, �-� r� connection with this permit and that app l i. t 3 1 ar ►�i tt� and�-o�',i,l 1 abide by the rules and regulations for permits es 'p �itdn the ToWf� `flf South Windsor's Street Cut Permit Manual . * * P�RMIT TO BE. EpT 9N JOB SITE AT ALL TIMES. Issued by _ T i t l e .--�--' Date Comp le d ' Inspected B �._/j y APPLICATION FOR STREET'EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm Cc� C Phone No. Ala 5-6" Address of Firm e Location of proposed work 15 ZS N V1 I r+ Describe fully nature of permit requested Starting date G 7 Approx.time for completion d Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut E No.cuts Amt.of Deposit$ by {)Cash O Check# Cut size after Perm. Patch 5 k) No. Cuts p�� Final Billing$ 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 WINDSORIS STREET CUT PERMIT MANUAL. Signed: Date: Title: D.L.#: PERMIT SHALL BE KEPT ON 30BSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permitdoc