HomeMy WebLinkAbout07110050 Right-of-Way Permit11/08/2007TFiU ..9: 30 FAR 317
5712439 City of Cazmel: y. - 2002/003
FIPPPaVLD
Note: Open"atus in pavement require Board of Public Wort and Safety (BPWV APP!
LOCATION OF CUT/WORK: 4190-& ? P R C AA7J C c
TYPE OF SURFACE TO BE CUT: VP el ? 1-2 B
PURPOSE OF STREET CUT/VYO3tK Cvw seer Sczi. cr?si.?a yr l
DAT R OF PERMIT: 04-a7 ESTIMATED DATE OF WORK:
APPUCANT'SNAME PHONE:
ADDRESS: '2/& E ?7 ?ih+ it+°o/5 /fv v7
WHO IS APPLICANT DOING WORK FOR: jgg) ?,e r i DD E
ADDRESS 0 '20 Y , ?r?Ly4a9E PHONE: ?13-11,30
NOTE: BINDER SEPARATE CO OVIDE NAMES AND CONTACTS OF ALL SUB-
CONTRACTORS TO BE INVOL IN N-SITE WORK ON TffiS PRO.IECT.
PERMIT ISSUED BY. (signauffe)
SURETY BOND AMOUNT: I/$ ? e°
BONDING COMPANY: cs Cuf?_
As applicant for this right-ofway/street cut pcmdt, I understand and asm to all the specifications and
conditions listed on the reverse side of the permit.
(Applicant's Signature)
RELEASE OF itIGI3T-OF-WAY/STREET CUT REPAIR WORK
I have inspected the repair of the above right-of-way/streat cut and find it to be completely satisfactory.
DNgMDWF?
NOV 1 3 2001
(City motor)
if applicable:
(Date)
Check returned: 83r