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Obstruct 106th/Haverstick-Gray APPLICATION OBSTRUCT,COUNTY HIGI-!W,,~.> {TEMPORARILY) NAME OF APPLICANT City of Carmel, Indiana ADDRESS 40 East Main Street PHONE CITY Carmei ' STATE Indiana ZIP CODE 4~032. APPLICANT IS: INDIVIDUAL PARTNERSHIP NATURE OF OCCUPATION OR BUSINESS Municipality PLACE OF BUSINESS City Hall CORPORATION X The above named applicant thereby requests permission of tine Board of Commissioners of the County of Hamilton, State of Indiana, to obstruct, tempor~ri.ly, the following designated county highway or higways: the north edge of 106th Street between ~rive East and Gray Road . %1e ~ ~ ~ek-- on the following date or datDs Approx. December 1982 · to__A?ril for 'the pu~p0se of c0hstructing a'12" water'main 19 83 (mpving a'h0use, cutting trees, to ].ay wzre, cable, pip, conduit, etc. The undersigned applicant hereby promises and agrees, in consideration of the grant of this requested permit, to post 'surety bond, payable tO Hami. lton County, in the penal sum to be designated by the Board of Commissioners in its permit, which i,, bond ~will be Donditioned upon complete restoration of affected highwa~ or highways to their original condition and to indemnify and ho[!.'_'{ Hamilton County harmless from any and all loss or damage caused by applicant, its ·agents or employees~ during the time said highway or highways are obstructed or as the result thereof. CITY OF CA_R}{__EL, INDIANA (name of applicant) DATE PERMIT Permission is hereby granted/rejected the above named applicant {o obstruct the designated higlnway.(s) te.~orarily on the dated indicated for the purposes set out, subject to applicant posting surety bond in the penal smm fi×ed below. (All pursuant to Burns Ind. Statutes 36-717-720 - ~cts 1947, ,Ch. 120, Sec. 3 and 5, P. ~73, in- corporated herein by reference AMOUNT of BOND $ ATTEST: APPROVED BY THB BOARD' OF CQF~'ISSIO, N~,qS OF HAMILTCRq COUNTY APPROVED BY COUNTY [-]IGHWAY SUPER/!?' ~ FOR BOARD O,P CONPIlSSIONhiRS BY: HAMILTON COUNTY HIGIIWAY SUPERVISOR DATE: