HomeMy WebLinkAbout07090108 Right-of-Way PermitBEM I KISS
POOLSOFFUN+N FAX NO. :13178236757 Sep. 24 2007 04:34RM P2
APPROVED
RIG -OF
Note: Open cuts to pavement require Board gfPub/rc Worb (3P W) Appr oval.
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LOCATION OF 7
TYPE OF SURFACE TO BE
PURPOSE OF STREI Ifi WORIC T
442? TIMATED DATE OF WORT + 4p2: --
DATE OF PERMIT: Z
AppUCANT'SNAME C/9F ?UAJ PHONE: 31-7
ADDRESS
WHO IS APPLICANT DOING WORK FOR:
ADDRESS: elwks Crc-e4
61
PHONE: 3' 77
NOTE: UNDER SEPARATE COVER, PROVIDE NAMES AND CONTACTS OF
CONTRACTORS TO BE INVOL N-SITE WORK ON Tl?S PROJECT.
PERMIT ISSUED BY: (sib)
SURETY BOND AMOUNT:
ALL SUB-
BONDINO COMPANY:
CERTIFIED CHECK AMOUNT: _$
BANK- CHECK NO.
As applicant for this right-of=way/street cut Permit. I understand and ages to all the specifications and
conditions listed on the reverse side of the permit,
• REPAIR WUai
RF.* ti. e R • OF I OF WAY/eTREET Cl tr7
I have inspected the repair of the above right-of-way/street cut and find it to be completely satisfactory.
(City Inspector)
(Date)
If applicable:
Check returned: BY