HomeMy WebLinkAboutCAble Street Cut Permits 90 Wood Pond Ro Permit No. 3016
Date 0,8/18/2000 Town of South Windsor. CT
Street Excavation Permit
Expiration Date 08/18/2001
Descrip CABLE MAIN FROM 90 TO 105 WOAD POND
Applicant
Location
Name COX COMMUNICATIONS
Addr. 801 PARKER ST. G090 WOOD POND ROAD
06040 CT 06040 Type of Mork CABLE
Phone (860 )432-5211
Applicant agrees to furnish the Town of South Windsor the amount of bond
required and to reimburse the Town of South W11ndsor for any expenses
incurred by the Town for maintenance or repair work in connection with this
permit and that applicant is familiar ,with and,,will abide by the rules and
regulations for permits as 'outli'nned in the Town
Cut Permit Manual . of South Windsor' s Street
4ei * PERMIT TO JB EPT ON JOB; SITE ,AT ,ALL TIMES.
Issued by .. , '�;
Title
Date Completed; Inspected B _
Y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $2500
�z- z
Name of Firm Phone No. &�— -3 r4
Address of firm .
Location of proposed work- a,
Describe fully nature of permit requested
Starting date____5 Approx.time for completion I It A� -
Call Before You Dig No Traffic Services Control No.
[indicate
how sketch of proposed work or famish To be filled out by Town of South Windsor
wo copies of separate drawing
Pavement cat t
North '
Prop.size of cut
No.cuts
Amt.of Deposit$ - by
-O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing
Amt. Due Payee$
Amt. We Town$
Applicant is responsible for contacting by
the Police Dept. and C.B.Y.D. date
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 PERM
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. ITS AS OUTLINED IN THE
Signed: Date:_
Title
D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
Mass ID#17930 Fax 781-721-0047 ' /
DIG SAFE NUMBER 2000 ,3`t'64
Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON �2. AT 7:00 AM
Contractor#1187
Date $ �� MAIL MUNICIPALITY
/00 E
STREET ADDRESS & DESCRIPTION
(Apartments&Condo's must list name of complex-Or list the
L �S
number of feet from the cross st as well as N,E,S or W
CROSS STREET �a �,ti ;, , /,/, AREA MARKED ? YES
WORK: Installing-CAT/ Utilities Notified:Ck P Va"Lj-. C rLj&&4 Town q 67 LLLgfLg�
DEPTH: 24 �D1�►r► d <�Q fa(a)i rid S0e SIV -V
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