HomeMy WebLinkAboutCAble Street Cut Permits Trumbull Lane Permit No. 2603 Town of South Windsor, CT
Date 02/17/1999 Street Excavation Permit
Expiration Date 02/17/2000
Descrip: INSTALL 8' GROUND ROD A V` I",-RUMBULL LANE
Applicant
Location
Name COX COMM UNICATI ACROSS A� MADISON WAY
Addr. $01 PARKER ST.
' k
06040 CT 06040 Typ p , I�Por CABLE
Phone (860.)512-5000 ,
Applicant agrees p fah ofW dsor the amount of bond
required and to re i r* "e 'o t�� uth'' or_.for any expenses
incurred by the Tows fob I 1 dk ep � �v in connection with this
permit and that app w 1,11 abide by the rules and
regulations for per0itt Ov,°"dttl1 i 'T Y1 ` ''South Windsor's Street
Cut Permit Manual . 4"
* * PERM T T6 B �; .�U � T7=,AT ALL TIMES.
Issued by .� itle ����
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm eb, e...vH uv, &44. Phone No.
Address of Firm An I f4ekee s7
Location of proposed work TR u w" (v/[ ,r jqcro 5 Mqd iso4
Describe fully nature of permit requested ks
Starting date—Til7l Approx.time for completion
Call Before You Dig No. 4$F- -034 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
Pavement Cut
Indicate North 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 by date
the Police Dept.and C.B.Y.D.
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: 00PDate:-
Title: D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits Street Excavation Permit.doc