HomeMy WebLinkAboutCarmel ROW Permit - FedericiRIGHT-OF-WAY PERMIT
PERMIT NUMBER: O Zca) ) 11 —
TODAY'S DATE: 1/30/19 ESTIMATED DATE OF WORK: 3/4/19
APPLICANT (Person doing the work) Jordan Stocklin
COMPANY: CASE Design/Remodeling
ADDRESS: 99 E. Carmel Dr. Ste. 100, Carmel, IN 46032
PHONE: 317-846-2600 EMAIL PERMIT TO: )stocklln@caseindy.com
CUSTOMER: Federici, John & Devana
ADDRESS: 12966 Pontell Pl., Carmel, IN 46074
PHONE: 317-496-8025
""-iQin,eering Dept
ADDRESS OF PROJECT: 12966 Pontell Pl., Carmel, IN 46074
DESCRIPTION OF WORK (check all that apply)
ROAD BORE DRIVEWAY REPLACEMENT
CONSTRUCTION ENTRANCE _ LANE CLOSURE
STREET CUT ROAD CLOSURE _
OTHER _
DESCRIPTION:
TYPE OF SURFACE CUT (if applicable):
*NOTE: OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPW) APPROVAL*
USE OF HEAVY EQUIPMENT YES V NO
DRAWING ATTACHED YES NO
*NOTE: ON REVERSE SIDE OF THIS PERMIT, PROVIDE NAMES AND CONTACTS OF ALL SUB -CONTRACTORS INVOLVED
SURETY BOND. Please see Item #1 of the Right -of -Way Conditions.
BONDING COMPANY: The Ohio Casualty Insurance Company
BONDING NUMBER: 32S591933
EXPIRATION DATE: 9/5/19
As applicant for this Right -of -Way Permit, I understand and agree to all of the specifications and
conditions listed on the attached sheet.
Jordan Stocklin 7
icant's Signature)
PERMIT GRANTED BY:
(City O'Tfrcial)
Print Name)
DATE ISSUED: /z/ q
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COMMENTS:
C
REPAIR WORK INSPECTED AND APPROVED
I have inspected the repair of the above right-of-way and find it to be completely satisfactory.
(City Inspector)
(Date Released)
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