HomeMy WebLinkAboutCAble Street Cut Permits Between 26 and Permit No. 2599 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
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Applicant Location
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Name COX COMMUNICATIONS EP, &16
Addr. 801 PARKER ST '`
g.
06040 CT 06040 W,6A, CABLE
Phone (860)512-5000
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Applicant agrees f,49� h of W rdsor the amount of band
required and to re ri �, �uSor i for any expenses
incurred by the Towp v;fb epayvoC in connection with this
permit and that app l Z, ht , � -*14 1 abide by the rules and
regulations for perma � t� „ � a , 3 i ,f South Windsor's Street
Cut Permit Manual
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* * P5E5MIT fO 1 EI fi � j =-TE�IXT ALL TIMES.
Issued by i t 1 e
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$25.00
Name of Firm O v� Phone N �e✓��?i (�Address of Firm 7 . j"� i:i
'Location of proposed works t�-i '2 6i1�wr -,
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Describe fully nature of permit requesieci---LiozCr4?d un�a
Starting date Approx.time for completion Call Before You Dig No. 1q9j-a6d - 1?b -
_Traffic Services Control No.
Show sketch of proposed-work or famish o be filled out b own of South.Wind
two copies of separate drawing T v sor
Indicate North Pavement Cut
Prop.size of cut
No.cuts
Amt.of Deposit$ 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 t.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 E)(PENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION W 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 WINDSORI STREET CUT PERMIT MANUAL.
Signed: /
Date
Title:
D.L.#:
PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc