HomeMy WebLinkAbout052319-8TODAY'S DATE: 5/20/2019
(Person doing the work)
COMPANY:
ADDRESS:
PHONE:
CUSTOMER:
ADDRESS:
PHONE:
A Pr P R C' V -Z
RIGHT-OF-WAY PERMITSe
p
nrnw ear nn i�enrn. /1i'T7 / f — /�
ESTIMATED DATE OF WORK: 5/25/19-6/30/19
Britt Hutchison
3751 Carwinion Way Carmel IN 46032
713-253-1609 EMAIL PERMIT TO: BrittHutchison@gmail.com
Britt Hutchison
3751 Carwinion Way Carmel IN 46032
713-253-1609
ADDRESS OF PROJECT: 3751 Carwinion Way, Carmel, IN 46032
DESCRIPTION OF WORK (check all that apply)
DRIVEWAY REPLACEMENT
ROAD BORE ❑
CONSTRUCTION ENTRANCE ❑ LANE CLOSURE ❑
STREET CUT ❑ ROAD CLOSURE �❑
OTHERX
DESCRIPTION: Re -Grading Small section of backyard for patio
TYPE OF SURFACE CUT (if applicable): Lawn/Grass
*NOTE: OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPW) APPROVAL*
USE OF HEAVY EQUIPMENT YES �CxNO
DRAWING ATTACHED YES x 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:
BONDING NUMBER:
EXPIRATION DATE:
State Farm Insurance
5/21/2020
IrnnrAs applicant for this Right -of -Way Permit, 1 understand and agree to all of the specifications and
R2
fitinn,; listed on the attached sheet.
77//
Utcli
(Applicant's Signature
PERMIT GRANTED BY:
COMMENTS:
Rri+ Hi itrhisnn - -
(Print Name)
(City Off�icial)
Gt)o. /(,J- 5 -oma
DATE ISSUED: S
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)
L-lept.
E
s