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19060109 Right Of Way Permit
Crry OF CARMIR. RIGff4)& A(AY �I�iT�� BATE: /_-, _ 1 �'-- (Person dmMsevmt) EINIATED vA E CII=iAIom- _ " / ,2- -- L Pam' r� � .L�— -5EfiWL PER1 TTO: ADaRESS OF PRQiWr DESCCFUFT70N OF WORK (check agthat apPlyj ROAD BORE 13 I?RNEWAY REPLACEMENT ©A S MUCTION EMANCE Em LANE CLOSURE ,IREET CU- C3 ROAD CLOSURE )THER 13 EYPE OF SURFACE CLIT(if appErable): *Nom OPENI Jm"PA11SWaYTREQUW MMD OFPMUCWORKS ISM APFl OMW USE OF HEAVY EQUIPNI€ U YES ND 5 o-1 � DRAWNGATTACHED. YE NO cCia : ON S1DE DF'ei 5 FEe14IgT, pROME AND COMM OFALL INVOLvM �SURE'IY BOND, Please see Itean #2 Gfthe R'rght�€-�i�lay C ' BONDING MMPANY 10 �5' ff f V BONDING NUMB R: , EXPIRATION DATE: C z AsaPPJka"t.furtfrisRtgfit-rx iAloYPermr, I andemtwd and agree to off of tW s Cuthm and eonditt ns i6nd on the aMched sheet - ter) • A!G,; q � �5 i L--i5 R 1,- _ Z Z:7- I. _ ii�,.. - .4 4 GIIANj'ED BY DAIE MUED: REPAIR WOrdC HVPECTSD AND APPROVED 'have imWCt6d the mPair ofthe abmrre sight-Of-mmy and fbtd ittD be compieteiYsagsfacwr y. [My ftwecwr) (Date flied)