HomeMy WebLinkAbout13025 Wimberly CT ROWMY OF CAMEL RIGHT OF WAY PERMIT
PERMIT NUMBER:
DATE: ESTIMATED DATE OF WORK-
IT(Person doing the work)
PHONE:
ADDRESS OF PROJECT
DESCRIP170N OF WORK f dw& all #hat apply)
ROAD BORE ❑ DRIVEWAY REPLACEMENT []
CONSTRUCTION ENTRANCE LANE CLOSURE
STREETCUT [� ROAD CLOSURE
OTHER
YPE OF SURFACE CUT(Napplicable):
*NOTE: OPEN CUTS IN PAVEMENTREQUIREBOARD OFPW lCWORD (F,W APPROVAL
USE OF HEAVY EQUIPMENT YES NO -S'rn cj � � �cC
DRAWING ATTACHED YES C� NO
"NOTE: ON REVERSE SIDE of THIS PERMIT, PROVIDE NAMES ARID COIIITACYS OF ALL SUB-0ONTRACrORS HQUIN Wo
SURETY BOND, Please see Item #J. ofthe Right -of Wav Candksnnc_
BONDING COMPANY:
BONDING NUMBER:
EXPIRATION DATE:
As appiicamfor this Right -of -Way Pcrmil; i understand and agree to all of the speofc utions and
condkions listed on the attached sheet:
Pplicanfs Signature)
GRANTED BY: ( DATE ISSUED:
sty Official) ..
REPAIR WORK 1NSPECtED AND APPROVED
I have inspected the repair of the above right-of-way and hurl it to be completely satisfactory.
(City Inspector) (Date Released)