HomeMy WebLinkAbout13030198 Right-of-Way Permit ------ RIGHT-OF-WaV PE`RIMIFT
P-ERM;IIT`NO: v3� 7/3 / (' % Lf I�" ...,
• Note: Open cuts in n'aVeriient,require B.oaill of Public AFOrks (BP\\) Approsal
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DESCRIPTION OF VVORtC(check all that apply): Road Bore Construction Entrance `]
'Streit Cut Driveway Replacement Lanz.Closure _Road Closure, Other
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USE OF HEAVY EQUIPMENT (yes or no )yt.94. IF YES., TYPE OF HEA\'Y'EQL'IP\TENT (Bobcat or
larger) TO BE USED: 446J – j�44.1 • 4 vi,66 jam;-
TODAY'S DATE:, 3,-#.2E-7/3 .ESTIMATED DATE OF WORK:, P - —
TYPE OF SURFACE TO BE CUT (if applicable);
APP,L[CA1YT'S iV.4\!E (Person doing the work):07.yjn.r te/ .Phone: 33r 2 V
. Address; 6 323 Id c 4't� Witt
WHO IS APPLICANT DOING WORK F ^ Name:
G
Ac ,w,, /
Address: 4e027 *24/42/— Q .
Phone: 990 '19)7
)RAWING ATTACHED,(yes'orno) 7.f40 .
COTE: ON REVERSE SIDE OF THIS PERMIT, PROVIDENAMES ?ND CONTACTS OF ALL SUB-
:ONTRaCTORS TO BE INVOLVED IN ON-SITE WORK ON THIS PROJECT:
;URETY BOND: 'Please_see [tent I of the Right of Way Conditions
SONDING COMPANY:, BONDING
As applicant for this right-oi-i,-av pennik, I ondersta nd and agi e.ro all ihe,specifications and conditions
(tared on the attached sheer.
(.- .plic qt's'Signature)
ERyfIT GRAN.TED:.BY sr4I 2 . .
r3
:.it.y.O (P'ate Issued)
REPAIR)kORK INSPECTED AND:A-PPRO '.ED
I have inspected (he repair of(he abbYe fight-of-way and find it to be coinpleteiv sarisfactorv.
(City Inspector) (Date Released)