HomeMy WebLinkAbout1998-05-11 CATV Main Placement - Application for Permit •-15-ERM1T NO. --� CITY OF OLl
APPLICATION FOR PERMIT FOR INSTALLATION OF UTILITIES
OR FOR PLACING UNDERGROUND CONSTRUCTION
Name of Party or Organization performing work MediaOne
Address 1238 Grey Fox Road, Arden Hills 55112 Phone 34- Fax 651-490-1212
1. Nature of Work ?Ictcrn.Uwf o- al IAlhill( C$T✓
Type of Surface to be Disturbed ❑ Gravel ❑ Bituminous ❑ Concrete CA Boulevard
(Other)
2. Location I1.87r) S 041
Street, Avenue, and House number
(Additional information attached when necessary)
��
3. Size and kind of pipe, conduit or cable J — -4/ cE�te /.t. chc /--
Depth from Surface (Min. 18") 3i — GAG" q f cr, 5-5 s
4. Method of Installation or Construction (including method of compaction & excavation)
Plow ❑ Backhoe J Pneuma Gopher ❑ Bore
5. Work to start within 5 days and completed within 3C days thereafter.
6. Will detouring of traffic be necessary? A)C If so, describe rerouting:
For MediaOne
(Applicant)
Signed by j QL
Dated / ;).3 99 ✓
The date when work is completed must be reported to the person designed by municipality.
AUTHORIZATION OF PERMIT
Upon payment of permit fee in the amount of $20CA and in consideration of the agreement to comply in
all respects with the Street or Alley excavation ordinances and regulations applicable covering such operations,
permission is hereby granted for the work to be done as described in the above application, said work to be done
in accordance with special precautions required, as hereby stated:
l
-Co) rpsfor� s +2.r(t D >✓ < a.� nf2 r! 5 `e . s {- - ( 1. c - , o .
74
orf-i- Pt/ .4✓PO u 0.1c`51,, 1.0 GT �✓ .90 ( i • r Ii�S
e-e-1
/et/
w' •� g l„c; l� � � S ••• l�t r•h ; e_ 1'z 12
v„,46 rr,_5
It is expressly understood that this permit is conditioned upon replacement or restoration of the disturbed area to
its proper condition in accoriclance with the appropriate rules and regulations.
C o }-( Stud
vq5 " atr � '(hty
,1.0„r-1 eCt ' A (1`' APPROVED
5 Pro) (1
-0.4 '/ 1 DATED" 1,1A y qt4
/4°4G,^,tK' 101/47
U
Form MP113 White-MediaOne Canary-City
•
— '"� rTh—..._
''.N
rCQ --4------
1
•
, ... ...
1 .
___4
...
cr_ c...noolz) A.ve ,
::
_60p. ;\:11 0-----0-0-0--?--n--- ,
„ 1 01 -01G
14 1 1 d Oso : ANE.
/4
k›J 1 1 0 k.4 .It 1 A \\ • F 6- r9[2, c° i
‘ j3'.--- OS At't �1 0-- 2i5 pJ f�
0�/So \_--:253-0--- .-1 J. I s� I },_L-I I I 01 „
= 21
CO
ic)-' '''. 4 I Fj ill'. rj -
■ o l-O j ''
i
1 74I
loW . -.
MEN 1
- \L_81. . .
0 S, - c° •6
F /I 1 I
I I I
N I of o»
Z.m W ,-,-• E;--} 3 CP
- I v 1 I
V 0 � ®' 't I
I•J -1 _ , 1 }
,f1 l ' °
1"' NN W 9-.1w J
\