HomeMy WebLinkAbout052319-7APPROVED
CITY OF CARMEL RIGHT-OF-WAY PERMIT
PERMITNUMBER: - 'L Q� J S— y Carmel Engineering Dept.
TODAY'S DATE: 05/02/2018 ESTIMATED DATE OF WORK: 05/10/2018
APPLICANT (Person doing the work) Wesley Runion
COMPANY:
ADDRESS
PHONE:
CUSTOMER
Grand Contracting
802 E 86th Street, Indianapolis, IN 46240
(317) 552-2300 EMAIL PERMIT TO: wrunion@grandindustrial.com
GEICO
ADDRESS: 101 W 103rd Street, Carmel, IN 46032
PHONE: 858-213-4138 (Fabian Alpizar, Facilities Manager)
ADDRESS OF PROJECT: 101 W 103rd Street, Carmel, IN 46032
DESCRIPTION OF WORK (check all that apply)
ROAD BORE r DRIVEWAY REPLACEMENT [�
CONSTRUCTION ENTRANCE LANE CLOSURE
STREET CUT [ ROAD CLOSURE
OTHER
DESCRIPTION: Site Clearing and Utility Trench Work
TYPE OF SURFACE CUT (if applicable): N/A
"NOTE: OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPW) APPROVAL*
USE OF HEAVY EQUIPMENT YES r,✓ NO
DRAWING ATTACHED YES (►_—j► NO ✓
"NOTE: ON REVERSE SIDE OF THIS PERMIT, PROVIDE NAMES AND CONTACTS OF ALL SUB -CONTRACTORS INVOLVED
�W114D. riedse see item Irl of the Right -of -Way Conditions.
BONDING COMPANY
BONDING NUMBER:
EXPIRATION DATE:
See Attached Document
As oppiicant for this Right -of -Way Permit t understand and agree to all of the specifications and
conditions listed on the attached sheet.
Cr✓ T' C �/
(Applicant's Signature) (Print Name)
PERMIT GRANTED BY:
DATE ISSUED: �S
City O )
COMMENTS:
w u. P9>3 e
REPAIR WORK INSPECTED AND APPROVED
I have inspected the r it of the bove right-of-way and find it to be completely satisfactory
2
(City Inspector) (Date Released)