HomeMy WebLinkAboutCAble Street Cut Permits 36 Tumblebrook Permit No. 2682 Town of South Windsor, CT
Date 05/10/1999 Street Excavation Permit
Expiration Date 05/09/2000
Descrip: REPLACE HOUSE SERVICE CATV
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Applicant Location
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Name COX COMMUNICATIONS ' T1MB`E,E BROOK DRI
Addr. 801 PARKER ST. z
06040 CT 06040 .` of` Wo CABLE
. Phone (860)512-5000
'Applicant agrees 1:osras ► thr, 4�i qW or the amount of bond
required and to reimburses h C'o y oIt, so''th pr ._for any expenses
incurred by the Town fz ` •, 4 nter� i tepa connection with this
permit and that It
an "J abide by the rules and
regulations for permits `as Ott? Trrf. oth Windsor ' s Street
Cut Permit Manual .
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* * PERMIT . 0 $E Kl=1t TIMES.
Issued by 7t1e;
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Date Comple Qed pected 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 $25.00
Name of Firm X e Phone No. s
Address of Firm a St Coe eV`
Location of proposed work 36 Tvcy, ►roo
Describe fully nature of permit requested our Se u ce clry
Starting date Approx.time for completion_ 30 ri.ys
Call Before You Dig No. /?991903.232 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
r No. cuts
i Amt. of Deposit$ by
i
�� ()Cash ()Check#
i
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: - �-%T Date: Ll-ln
Title: D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc