HomeMy WebLinkAboutCAble Street Cut Permits Between 81 and `rt
Permit No. 2618 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND RODsFeR-' " -&T, ONEFIELD TRAIL
Applicant Location
Name COX COMMUNICATIONS wETyEl��Bir&93.
Addr.. 801 PARKER ST.
06040 CT 06040 Type it CABLE
Phone (860)512-5000
Applicant agrees t fih C +r0 of rdsor the amount of bond
required and to rei r ?the T0V r auth � xd or:for any expenses
incurred by the Tows, for n►�i repay *` in connection with this
permit and that app i,i i1111' abide by the rules .-and
regulations for
9 permits", a, rYv 000-1%,v , to South Windsor's Street
Cut Permit Manual .
* * PERMIT Sao BE, . gTE, T ALL TIMES.
Issued byrI`i t 1 e
Date Completed Inspected By
APPLICATION FOR STREETatoll
EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm (A L"-v--- Phone No.
Address of Firm L A 2 es s r -
Location of proposed work S`tOn dt13 `
Describe fully nature of permit requested 7-45 t) O
A-
Starting date Approx.time for completion
Call Before You Dig No. 06 p 7 Traffic Services Control No.
Show sketch of proposed work or furnish To filled ut b own of Sout Wind r
two copies of separate drawing be so
Indicate North
Pave---ement Cut
Prop.size of cut
No.cuts
Amt.of Deposit$ 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 6
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 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 2- //G �F 9
Date:_
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc