Fax transmission journal, Oct 11 2002

NYC 9/11 Public Portal Document

•. awYorkCky APPLICAT70N FOR CONTRACT PERMIT r. 7Mp— 6f Trwsport.tan ~mem ofPa~s Mac and Caa FwwCd n C I ml (REV.B-98)FFJ3wT

PERba T NMMER : P TE (MM0: 1 1579 CONTRACT e: Rom - Ret-M1 BOROUGH: QM OB OQ OX OS Dc OBNEC OQEC OBXEC OREC OCMC4 SPONSORING ). NCY: ®DEP DDDC ODOT ONYSDEC ONYSEDC OHPD OPARN OSCA. OHM OPA of NYW PROJECT IIIGL IThHE: R RAbwk %<p tsHN A RJ P. E . TELEPHOW 1: ('1' S - 3? 19

)Th}E OF CONTRACTOR: kT~o~.l !RCMen)lrrRO~l (au t (^1Sce CD.J ZOLTELEPBO E s: (51 ( ) 7 9 1 -300

BUSI)lSS ADDRESS: 3 O 10 a U Q ~5 A V c t, UE/ W A s.sTA b %174 -3 RESIDENT ENGINEER )AbE: TEIEPH #: ( )

PROJECT DISCRIPTION:8 11-Dt►l(r ErcTE12(ORL CRe AN•uP ACT%VIS(ES -rb REMoVF- 'nEAQ S CQ &A CONTRACT START DATE: ON ACT oo(MLETION DATA+ : N/3a/o2

TYPE OF PAVEHENT: ROADiAI: TYPE OF PERICT(S) REQUESTED (Check All Applicable): 0111-291.IoR INSTAIJ.AXION-SF' M f126 -TEST PITS, CORES OR BORING CRANE/SHOVEL ON STREET 0112-RAPID TRANSIT CONSTRUCTION 0132-INSTALL FENCE 0205-PLACE SHANTY/TRAILER ON 0113-REPAZRW TM 0135-I L RESTORATION STREET 0114-REPAIR SI 0136-DEP-EC.JOR INSTAT lATIONS_ 0208-TEMPORARI PEDESTRIAN VOLLK 0115-REPAIR WXTER/SERM VULTER 0211-TE~ORARI ROADMX CLOSING 0116-FUEL OIL LINE 0137-DEP-XWOR INSTAllATrONS- 0214-PLACE COWrA33MR CK STREET 0118-RESET,REPAIR OR P LAC ` SERER. 0215-TEIO?QRARI SIDERALK CLOSING CURB 0201-PLACE E4)IERTAL ON STREET 0401-REPAIR SIDEiALK 0119-PAVE STREET 0202-CROSSI SIDEWALK 0402-OONSTRUCT NER SWEV K 0120-TREE PIT 0203-PLACE CRANE/SHOVEL ON 0403-WS~cIACE SIDEWALK 0121-CONSTRUCT OR AL NHOLE STREET VENTII.ATORS AND/OR CASTING 0204-PLACE EQUIPMENT OTHER THAN OTHER TYPE OF PERIQT:

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OCW APPROVAL BY: DATE: OMORE: I.00ATIONS ON REVERSE TBE P T TO BE GRANTED SUBJECT TO THe FOLLORING CMMITIONS: THE APPLICANT AGREES TO COOLY WITH ALL EARS AND RULES OF THE DEP)RSIB:NT ARID OTHER APPLICABLE LAOS AM ROLES. NO P T SHALL BE ISSUID UNLESS THE APPLICMNT HAS ON FILE ALL INSURANCE(BOMS).

APPROVED FOR THE CO2MSSIONER BY: SUBIaTTED BY: 1V YC ') E P DATE: /o /!, l o-2

_ DATE: SIGNED BY: /€ • R JY '— N (7i 8 ) £' S- 3'7 2_f

NYC-WTC 000111715