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HomeMy WebLinkAbout14070070 Right-of-Way Permit � RIGHT-OF-WAY PERMIT ,�i � P � � ►,/ � � PERMTT NO: � Y Note: Open cuts in pavement require Board of,Public Works (BPW) Approval ADDRESS OF WORK; 11091 HINTOCKS CIRCLE N DESCRIPTION OF WORK (check all that apply): Road Bore . Construction Entrance X Street Cut_ Driveway Replacement_ Lane Closure_Road osure Other USE OF HEAVY EQUIPMENT (yes or no): c/��f IF yES, TYPE OF HEAVY EQUIPMENT (Bobcat or larger) TO BE USED: . LOADER, BA KHOE �L,;,r p �/2coi�/� / TODAY'S DATE: 7/OS/14. ESTIMATED DATE OF WO�: 7/16/14 TYPE OF SURFACE TO BE CUT(if applicable): /� p �v h APPLICANT'S NAME (Person doing the work): TE�Y PooL Co. ,INC phone: 317-872-2502 Adciress: 10350 NORTH MICHIGAN ROAD CARMEL, IN 46032 WHOISIAPPLICANTDOINGWORKFOR: Name: MR• & rt�s. Bttn� waxn Address: 11091 HINTOCKS CIRCLE CARMEL, IN 46032 Phone: 317—;07—;099 DRAWING ATTACHED (yes or no) Yes � "� � �� �� �� � � � (� � l,7 �� � � NOTE: ON REVERSE'SIDEOF THIS PERMIT, PROVIDE NAIvIES AND CONTACTS OF ALL SUB- CONTRACTORS TO BE INVOLVED IN ON-SITE WORK ON THIS PROJECT. SiJRETY BOND: Please see Item #1 of the Right of Way Conditions BONDING COIv1PANY: MERCHANTS B���G � IN 23214 As applicant for lhis right-of-way permit, I understand and agree to all the specifications and conditions listed on the attached sheet. �i/',C.c-0 �/��`�7 �ppkcan�'s Stgna ure) PERMIT GRANTED BY: o (City 0 al) ( at ssued) REPAIR WORK.INSPECTED AND APPROVED I have inspected the repair of the above right-of-way and find it [o be completely sa[isfactory, (City Inspector) (Date Relezsed)