HomeMy WebLinkAboutCAble Street Cut Permits 8 Windshire Dri Permit No. 2570
Date 02/17/1999 Town of South Windsor, CT
Expiration Date 02/17/2000 Street Excavation Permit
Descrip: INSTALL 8' GROUND ROD :P� CATV,''=",I,NDSHIRE DR
' Applicant �-
Location
Name COX COMMUNICATIONS
Addr. 801 PARKER ST. L1 0 ' OF HOUSE 8 AND IN
06040 CT 06040 Typw { jr CABLE
Phone (860)512-5000
Applicant a rees 9 1 f ti sh,,w . '� of
required and to re��mr 'te To 16dsor the amount of bond
incurred by the Tow uth „ y expenses
n sor ; for_ an
permit and that a � `; ep �� � in connection with this
pp � x�w t �°Will.` abide by the rule
regulations for perm7' s ds s and
Cut Permit Manual . � �� � � frSouth Windsor's Street
PERMIT dlq B '
T (E MO IT T� ALL TIMES.
Issued by
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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 $25.00
Name of Firm / DA" Phone No.
Address of Firm
Location of proposed work /
Describe fully nature of permit requested
Starting date Approx.time for completion -
Cali Before You Dig No. Ifff 406 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut'
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash{)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 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: z_, Date: ���( / �T
Title: D.L.#:
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
---Stadar eFms\Permi WtFeeh :x.a bon-Permot.doc
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