HomeMy WebLinkAboutCAble Street Cut Permits 29 Sycamore Roa "rermit No. 2792 Town of South Windsor, CT
Date 08/04/1999 Street Excavation Permit
Expiration Date 08/03/2000
Descrip: 29 THRU 45 SYCAMORE RD. - REPLACE MAIN LINE CABLE
Applicant Location
Name COX COMMUNICATIONS r 0(128 'Sl'GAMORE ROAD
Addr. 801 PARKER ST.
06040 CT Q6040 Type t�i' Wc�r� CABLE
Phone (860)512-5280
Applicant agrees to a ish , h 6 od-th 'W'in'deor the amount of bond
requ i red ;and to re i mbui^8q irk '�o�rr� o th W.fnddor -.for any expenses
incurred by the Town for "Th ertance' �or`':repair 'Work, in connection with this
permit and that appl ilct Ieith and, wi 11._ abide by the rules and
regulations for permits. a$ out�1�d '.irr tom' Towwn" c►f'' South Windsor's Street
Cut Permit Manual .
* * P MIT TQ KEPT QN :J09, SITE AT AtL TIMES.
Issued by Title
Date Completd,, ' Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH, WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Address of Firm Phone No.
Location of proposed work C0.
Describe fully,nature of permit requested q�
Starting date -
Call Before You Dig No. Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing To be filled out by Town of South w�nSISOr
Indicate North Pavemine- t Cut
Prop.size of cut
37 q S No.cuts
Amt.of Deposit$ by
,p `I {)Cash O Check#
T Q"t P LO Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting
the Police Dent_and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION
PERMIT AND THAT I.AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FORAS
THE TOWN OF
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. WITH THIS
PERMITS AS OUTLINED IN THE
Signed-
Title: Date:_
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc