HomeMy WebLinkAboutCAble Street Cut Permits 20 Skyline Driv P(,,rmit No. 2565 Town of South Windsor, CT
Date 09/ 17/1999 4 Street Excavation Permit
Expiration Date 09/13/2004R
3
Descrip ; CATV REPLACEMENT
Applicant Location
Name COX COMMUNICATIONS 0020 SKYLINE DRIVE
Addr. 801 PARKER ST.
08040 CT 06040 Type of Work CABLE
Phone (860)512-5280
Applicant agrees to furnlsh '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 matntenanee or repair work in connection with this
permit and that applicant is fam.i llar Wiith and wi ' l' abide by the rules and
regulations for permits as outlined in the Town of South Windsor ' s Street
Cut hermit Manual ,
* * PERMIT TO 8E'::> KEPT ON JOB SITE AT ALL TIMES .
Issued by
Title
Date Complete d %- __ — Inspected By ------`--
APPLICATION FOR STREET EXCAVATION PERMIT
-- TOWN OF SOUTH-WINDSOR
PUBLIC WORKS DEPARTMENT-
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm LOX CC-i blC_ Phone No. 'ECO 51-9-57986
Address of Firm Of r1rWr ST RY#--?c4eXr;P_r
Location of proposed work S /-7
Describe fully nature of permit requestedevr�►-
Starting date 9 Approx.time for completion 1
Call Before You [fig No./9993802 706 Traffic.Services Control No.
Show sketch of proposed work r furnish To be filled out by Town of South'Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
. I No.cuts
- �+e V'
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm.Patch
No. Cuts
Final Billing$
Amt. Due Town$
Applicant is"responsibie•for contacting by date
the Police.De .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: 7
Title• D.L.#•
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc