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Right of Way Permit
Y OF G4RMEL RIGHT-QF-WAY PERMlT PERMITNUMBER: r Z.. --/� DAY'S DATE: �, ESTIMATED DATE OF WORK: f�' Z�� t Q APPUCANT (Person doing the work) �(GL(�jL� ���� � �� � _ w��� � iCOMPANY: ADDRESS: PHONE: CUSTOMER: ADDRESS: PHONE: � t _ Is-� �LL_I�4-�K CsOT �Q�l ty � OJ�� Z 3� � GL�� S`T' C4-Lz'�C. �l (� �3Z 3�73iz�'��I EMAILPERMITTO:W��Ij�/l�� ��OS/USL"C�r{�i4/�• �C417�GF,��t� ct,Wtc- G�G- B��el.i� �Z 0 �. 1Z�G,ELI�F' I� �.�v'.K� __ _ __ 3� �- ro/ - Z s 7 s ADDRESS OF PROJECT: I�� �. ���L��}� � C�,�ys�-`�C DESCRIPTION OF WORK (check all that apply) ROAD BORE � DRIVEWAY REPLACEMENT �] CONSTRUCTION ENTRANCE ❑ LANE CLOSURE � STREET CUT � ROAD CLOSURE � OTHER i-1 DESCRIPTION: {City � TYPE OF SURFACE CUT (if applicable): �„� � rJEs' *NOTE: OPEN CUTS IN PAVEMENT REQUIRE BOARD OF PUBLIC WORKS (BPWJ APPROVAL * IUSE Of HEAVY EQUIPMENT YES n NO � DRAWING ATTACHED YES Q� 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. 1� n,/ �� (. f^� BONDING COMPANY: ,(.� �'l-� ('' (�,a,�� S BONDING NUMBER: �Q �'p Z Q��✓ b S EXPIRATION DATE: FC'�,(3 �•L�' Z�ZO As applicant for this Right-of-Way Permit, ! understand and aqree to all of the specifications and � l conditions listed on the attached sheet. W t L� 1�--�-1 G. � C�S 1 tt.s icant's Signature) _ (Print Name) PERMIT GRANTED BY: COMMENTS: 6 DATE ISSUED: // -�-�' �' z b� �'� l� � 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) J /-�QP�aJ.�o �Y P��� (�� �YoJ 7 �-� +fk5�l�r � l 4 � oo�o � ,� ; ��a,�:.,a�._.:, � � -�• �.., _ ..... . .. . ..... . . ...... ... . '. �, .�:aK � .. � �'.'^'�t. .� �. ...... .�. . �.a. ..�'�'�i 1 �"'�^'4 ^ ' .. . . . �,� . . .�........_. ,, i . �`� �4.. Y .� . ` b C.: +�,�:. � i . . � .�.. .`q .� '!�. ,t ,� . � , � 4 ' r � .� ,x. .� �'� J ; .�;, ti-� . . . �� �� �, �� �"^� �� i � � �.S �; ' °�•...,, . . .. ,,� �. `:...��+ ,� y: �_. ,� ,,,�I - _ } "�" "� �.«". �t'-: t �e. ,� -ti.2' -.. 'wt. . � �.,«<._�„ a rt,.,,� �`'"- • � z� "'��"�'^�'^'�'�'w.�......�_�4..� �s..— "x .:..:�` e�".. .,�..;�.. . '�.. ti j'" � +�».�t�„�'"� ,� `� � �� � �� ���� . �„�. "� � �� '. .Y�... i1� r � � � �n �� � � , ���� �°r"P �n � . --�. ,K� ����� � P �� �� ,� . � f x��F�+. 8-F1 5t��"`irj � i? '�Ns4i� �� � � + l ys F�v _ ; �. :�� f� • �',� � . , ,a } '. � { ti , i'y., +�..,.'' � . . ti.:�,. ' �_� tti � .� _ � � � '�..t, � . .. .. . ,..:s.; .9 P-�+ _,^� � � �� � � —.� C-Y. .�" �'- 1 ��` ' �. R j; u . .. , ,. y � . ' w.�....r.......... .Ya ' � . � �w.+' , � ,� ; : . y `� : �� r._. � -w ,. ty' .. -. � � „ � . { j;, \. :. �'t'+.. � •-.I": � �. . .. . if 1 �. � . y_r , . � . . . y?�� . � �, r*,$ � .� ,_ . � �4 � � ' . � � ��_. v.,��, . . _ _.___�. ... � � r _, � .; �"' , � � _, ,�� � �: � y � 'z : �.,:� � � �, '�``� !° :_..�._....n. � ��.�', �,°�pr yt: '"" �� . r. ;;" � - _._._. _._..._ _ ""� ` �"� i ,,v`e, ,.� �.. '�{ � ' ', •` � ., , ;r_. �.. . 1 ° � *-.. t . � � . _ ,:_ . � � :',. -...._. �� �� `� ��. +o�i c.. +'!' '"ti � k � �� � � .� ���� . -_"" : � ,;`� ti., ., 'A �� ___._ _�.. � � � ��' � �„ � .�._ ...�_._ _ .._.._._.,_,.. . 7 ,�, ,�;� -s. � �. k., �; .� : � � �;; 1 � � � :,� y } �i{ � '�� S3 �' 4 w'A.+ -�. ��r �. ^,�J :;•, •,� ' ' �.. — �. y: � ;,��. •� � � �'� �w ,�� , ":___. _ +`�.-w» .2'„� ,t �:y, �, *a r M... . . � �.:. 9 � .r � ,;� ., ��. � t � ��•,; 4 aY�;'�.. a: .. . ,�4y . ; ` ��Fn! � �r � � � .. � � �{'�� 4 �., � � .. �.. � , . r, �. � �j � r� �� w .� � t ; .� R'` �_..._.� •„,}' Y!� ..� ' „�" i�& `'.. "4 �.� � .,. ^ K, . � �`f c...;i � ��j • . , ..,� 4 �? k �.::,�, Vi r�^. � w.:�� � , . `ti ,"< � � iAM C";�q_,� � i � �. -�.. y+��J�� . . $ �'. . .';,i�.. C«�.!l.Y}' `�1' L.Z' 1 X�y � . 1 , s _......_.»_.��..._...,.,,�.:.._...__... -..»._.......,....,,....,...,....,-..»...,.......�,....._.,.<.,,�......,->...�....�......,.....,_-..�....»:....:.. i . ....,.,,..........-....-.�.��,.,. . _. � t ��x� �S� � � . . .. . . . � . . ✓'�'�Y . . � . � � . . � . . � � . �. � . . . � �, `� M � . ' � � � � . � � . � . .. . . . &� � � � � � .. � � �� .. . . � � � � . �K fi 4�• . . . . . � . S � kyv� . . . � . .. . . .