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HomeMy WebLinkAboutRight A Way - Approveda CITY OF CARMEL RIGHT-OF-WAY PERMIT PERMIT NUMBER: Carmel Engineering Dept. TODAY'S DATE: J'( Zj 23 ESTIMATED DATE OF WORK: Se47 � APPLICANT (Person doing the work) COMPANY: ��l�ruf� P�Qt✓S CDiL ADDRESS: SZS �LI'�iGydd V Tn��y !(Z -3p PHONE: 3�7-78 Z– j' �(O EMAIL PERMIT TO:�0 l5 CUSTOMER: Scan f �CG� �. 6 1zz �-S G,.�t Uri ! G25� � ra c C ,G`.�•� y/y ADDRESS OF PROJECT: DESCRIPTION OF WORK (check all that apply) ROAD BORE ❑ DRIVEWAY REPLACEMENT ❑ CONSTRUCTION ENTRANCE ' LANE CLOSURE ❑ (STREET CUT E ROAD CLOSURE ❑ (DESCRIPTION: -e S$ �7px6iK 4 TYPE OF SURFACE CUT (if applicable): "NOTE. OPEN CUTS IN PAVEMENT REQUIRE BOARD Of PUBLIC WORK5 (BPW) APPROVAL k USE OF HEAVY EQUIPMENT YES fd NO DRAWING ATTACHED YES 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 CondltiOnS- •G- � � (_V BONDING COMPANY: k•; c c,•c2 BONDING NUMBER:LS Q DC7 --7 EXPIRATION DATE: r —f,, – o As applicant for this Right-of-Woy Permit, I understand and agree to all of the specifications and conditions listed on the attached sheet. (Applicant's Signature) (Print Narne) PERMIT GRANTED BY: (City Official) DATE ISSUED: COMMENTS: 75-796 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) TCD � � � � � / �� \ �LA, 23 \ / (\ \