HomeMy WebLinkAboutCAble Street Cut Permits 251 Skyline Dri Permit No. 2756 Town of South Windsor, CT
Date 07/07/1999 Street Excavation Permit
Expiration Date 07/06/2000
Descrip: CABLE SERVICE
Applicant „ W, Location
Name COX COMMUNICATIONS ,�' 026),� aYL1�1 DRIVE
Addr.. 801 PARKER ST.
06040 CT 06040 T`Yp6 of�, 6,ABLE
Phone (860)512-5000
ep
Applicant agrees to Ur tla Tdi�t1 Sc1�ih intitsr the amount of bond
required and to reimbrse1"ov�n s ' `� h W + r'°,- cr any expenses
incurred by the Town car mXA' tGO a i r'� connection with this
permit and that gpp 1 i caD '� ar ��tr � � Ti de by the rules and
regulations for permit -a'- t ��xalf � ath Windsor's Street
s
Cut Permit Manual .
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ERMIT TO V�T, � � � LL TIM S. * �
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Issued bye,Mµa �Y+
Date Completed ~1 Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
,,�/���// FEE $25.00
Name of Firm ery'J'c° Phone No.
Address of Firm
Location of proposed work ?
Describe fully nature of permit requested en&e
Starting date Approx time for completion y,
Call Before You Dig No. Traffic Services Control No.
FShow sketch of proposed work or furnish To be fille out b Town of South Windsor
copies of separate drawing y d
Indicate North Pavement Cut
Prop.size of cut
�) No.cuts
( Amt.of Deposit$ by
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 C y and .B.Y.D. date
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 JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc