HomeMy WebLinkAboutROWPermit-Carlisle(pdf)CITY OF CARMEL RIGHT-OF-WAY PERMIT
PERMIT NUMBER:
TODAY'S DATE: 10/07/2019 ESTIMATED DATE OF WORK: 10/15/2019
APPLICANT (Person doing the work) Pools of Fun
COMPANY: Pools of Fun
ADDRESS: 3891 Clarks Creek Rd.
PHONE: (317) 839-3311 EMAIL PERMIT TO: kaCOlon@poolsoffun.Com
CUSTOMER: Sara & Chris Carlisle
ADDRESS: 5925 Tall Timber Run
PHONE: 414-943-7178
ADDRESS OF PROJECT: 5925 Tall Timber Run
DESCRIPTION OF WORK (check all that apply)
ROAD BORE ❑ DRIVEWAY REPLACEMENT ❑
CONSTRUCTION ENTRANCE ❑✓ LANE CLOSURE ❑
STREET CUT ❑ ROAD CLOSURE ❑
OTHER ❑
DESCRIPTION: Side yard of house
TYPE OF SURFACE CUT (if applicable):
*NOTE. OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPW) APPROVAL*
USE OF HEAVY EQUIPMENT YES B NO e✓
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 Conditions.
BONDING COMPANY: Westfield
BONDING NUMBER: 0259-568
EXPIRATION DATE: 04/29/2020
s applicant for this Right -of -Way Permit, I understand and agree to all of the specifications and
/ conditions listed on the attached sheet.
(iCi Katie Colon
Ap licant's Signature) (Print Name)
PERMIT GRANTED BY: DATE ISSUED:
(City Official)
COMMENTS:
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)