HomeMy WebLinkAbout19060207 Right-of-way PermitRIGHT-OF-WAY PERMIT
PERMIT NUMBER: QS '-5
Carmel Engineering Dept.
TODAY'S DATE:
05-13-2019 ESTIMATED DATE OF WORK: TBD
APPLICANT (Person
doing the work) Jason Bosaw
COMPANY:
Sunco Construction Company, Inc.
ADDRESS:
319 Harlan Dr., Mooresville, IN 46158
PHONE:
(317) 370-7193 EMAIL PERMIT TO: jbosaw@suncoconstruction.com
CUSTOMER:
Trilogy Health Services, LLC
ADDRESS:
303 N. Hurstbourne Parkway, Suite 200. Louisville, KY 40222
PHONE:
(502) 727-7449
ADDRESS OF PROJECT: 12315 N. Pennsylvania St., Carmel, IN 46032
DESCRIPTION OF WORK (check all that apply)
ROAD BORE I DRIVEWAY REPLACEMENT
CONSTRUCTION ENTRANCE C LANE CLOSURE _
STREET CUT C ROAD CLOSURE
OTHER V
DESCRIPTION: Courtyard, concrete, install pergola, fencing, river rock.
TYPE OF SURFACE CUT (if applicable):
*NOTE. OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPW) APPROVAL*
USE OF HEAVY EQUIPMENT YES NO
DRAWING ATTACHED YES NO a
*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 Cond. ions.
BONDING COMPANY: Selective Insurance
BONDING NUMBER: B 1214318
EXPIRATION DATE: 04-03-2020
As applicant for this Right -of -Way Permit, 1 understand and agree to all of the specifications aS��
nd
conditions listed on the attached sheet.
Jason Bosaw
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PERMIT GRANTED BY:
(City Official)
(Print Name)
DATE ISSUED
COMMENTS:
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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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