HomeMy WebLinkAboutCAble Street Cut Permits Strong Road/Ban Permit No. 3042 Town of South Windsor, CT
Date r 1a 10/30/2000 Street Excavation Permit
Expiration Date 10/30/2001
Descrip: CORE BORING UNDER STRONG RD
Applicant Location
Name COX COMMUNICATIONS s�' OiC� RD ,AT BANCROFT
Addr. 801 PARKER ST.
06040 CT 06040 `
Type 'of Work CABLE
Phone (860)432-5211
Applicant agrees to furnishT.th 1 � ' f do "tk`Windsor the amount of bond
required and to rei mtrui d- Xtlh 0 ,�`owx�. cjUth W`*x)d66r for any expenses
incurred by the Town for 41inen,an 'r~epa'ir Wbdrk in connection with this
permit and that appl scant A faml tH ��tb and f"I l abide by the rules and
regulations for permit � a Qt t : 'era � Tawn,'bf. South Windsor' s Street
tut Permit Manual .
* RMIT l' 9C f T Q fiT4wALL TIMES.
Issued by T i't le
Date Complee
�� - Ibspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT -
FEE $25.00
Name of Firm COX CjUkitAi 1CAV180 Phone No. 1960—sla • Z�"Q
Address of Firm
. Location of proposed work r-b
Describe fully nature of permit,requested >c
Starting date l -- Approx.time for.completion 1-
Call Before You Dig No-120M 4 Traffic'Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pave ern nt Cut
Indicate North _ Prop.size of cut
No.cuts
Amt.of Deposit$ by
1.. � O
IN
O Check#
Cut size after Penn. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
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 AMOUNTOF 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: D.L.#•
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
y Mass ID#17930 Fax 761-721-0047 A o 00 ��D���� `.
DIG SAFE NUMBER `)
Conn: Ph: 800-9224455 DIG SAFE CLEARS ON �/ �� AT 7:00 AM�
Contractor#1167
Date /00 EMAIL MUNICIPALITY S CU J
STREET ADDRESS & DESCRIPTION
(Apartments&t from
the must list name of complex-Or list the �/ A
number of feet from the cross st as well as N,E,S or W) o /
Est C-11- et)Ff— G/y
CROSS STREET R.A AREA MARKED ? YES
WORK: Installing CAN Utilities Notified: c-LLP JaA n r 6n—q Crt jo ` L v
DEPTH: 22 b U.L. -e. 1'l E�c�2 CnT r-(q.Lf -r uln .S. LcJ i n
6-T C7-
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