HomeMy WebLinkAboutCAble Street Cut Permits Between 2 and 4 Permit No. 2540 Town of South Windsor, CT
Date 02/16/1999 Street Excavation Permit
Expiration Date 02/16/2000
Dascrip: INSTALL 8' GROUND ROD�"""C,ATV =�-,VZCTORIAN WOODS
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Applicant Location
Name COX COMMUNICATIONw � QUSE 2&4
Add r. 801 PARKER ST.
06040 CT 06040 x10 Typ� S �ri� CABLE
Phone (860)512-5000 ; a�
Applicant agrees WO '-ah= of dsor the amount of bond
required and to reiurs tie Tcwbuth htlsor for any expenses
incurred by the Town a°r tipi P ep wickj in connection with this
permit andthat ape irJas, f wig 1` abide by the rules and
regulations for perats $ �: �� � saw ��6f„South Windsor 's Street
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Cut Permit Manual .
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* * PERMIT T ALL TIMES.
Issued by i t l e
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Date Completed Inspected By
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01 yo
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm- Z -'o n
Phone No. �� I —,$� �D
Address:of Firm 0
Location of proposed work R
Describe fully nature of perrhit requested rg 6--6a . ,4-7`1
Starting date Approx.time for completion
Cali Before You Dig No._Z&.9 QG4 QQq1:7 Traffic Services Control No.
Show sketch of proposed work or fumish 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
()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. Date 2 ��
Title:—OLL� D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms Permits Street Excavation Permit.doc