NYC 9/11 Public Portal Document
ri:Ciy APPT.TC-4770N FOR CONTRACT PERMI
arTrimpon"M
W■ ethr t Maoaemm[ _• Cana.aia• CY~d ml ONO.S—s )PB~T
PEE~TME (Mae I: OONTRALT I:
aormGH: am OB OQ Ox OS Dc OENEC OQEC OBxEC OREC OCMC#
srONSOP. )GENcT: Dc ODOT DNTSDEC DNISEOc OHM OPARSS Os ON= Dpi of azssr
PROJECT arm HAM: 'R _ RAA 41A sjt j1 1E rEraPeose *:1 (71%
zus or ooNTRAc=:Jkh nA 'Qewed4; s,~ Tr%c I F;LV.4.?F as E a: (Sff) 181- 3e o o
susnNEss ADDRESS:AQIb 'l?iurnC Aver ,e I WaMagM N'1 1%793
RESIDENT 1Th : 1$EPHQNE t: ( )
11 1'
PROJECT DESC1 t=CaN:~cAM1v'0 Flt4orinr nlaa,n~.., d..~:.~..1:~ 1... *'-_--
ZTIOND :
%tI& /o2
TSPE OF PAVEMM:
TYPE OF PERHIT(S) REOQESTEO (Cpeck 'TT Aaolicable):
D111- OR INSULTTAMM- 0126-ZEST PITS, COStFS OR DCRMs OR E/SHOVEL O STREET
0112-RAPID TRANSIT OONSTRHCTION 0132-3g5TALr
i 0205-PLACE TSHANTZ/27.xLS7c ON
0113-REPAIR vomm 0135-rn i. HFSTORATION STREE
0114- AM SERER 0136-DEP-HAoR 1NSTALLA•rrQQS- 02O8- 7(py PF.7ZES IAn jK
0115-FXPAIt R/SERM --
0116-TUEL OIL LINE )9211-MMWMRI7 PD DWX CLOSING
D137- - JoR IAS171LLA,2TC6S- 0214-PLA
0118-RESET.PPAM OR RE4LACE ON STREET
SEINER 215-TEHQORARY S=MDZK Cz"-nu
CU 0201-PLACE hVmm1A1 ON S7+T
0119-PAVE STREET 0401-REPAXR S71)EfpLN
0202-CROSS SMzRux 0402-OONSTR=r NEW SI
0120-2RE£ PIT =
0203-PLACE cpj=/SEOc' , ON 0403- LA a SZD~iK
0121-CCKSTRDCT OR ALTER l9 MOLE STREET
AND/OR CASTING; VENTXLRIOPs
S(2O4-PLACE EQOIPENE OTBER TSAF
OTMR TYPE OF PEMaT:
STT t ram saa: ZZKCKK IRM _
TO S E rffi SSASS
! MUR K( 5Y Ch ( 'c"
&} I%i'J rOG~A /OZO ~S
-saws:
59 mat +•i I c,L - c
AT1C
I 19/,20 Iboi
1-(d5 W-GAOAO.
l~lw-ra S~ I O 10 / S
I -L si-. I /o'O I$:/ S
l
-3 3 Qes~ 3(►oc~ol
TO_T1C
rc SL. I )ortv- S 4 20 V°/l
Col I.JARRX9 ST WpS I%o 0
O APPROVAL H::
DAZE:
LOCATIONS ON REVERSE
?R P T TO BE GRANTED SO®JECT TO
T)2 POLL I1tG ITIMS:
TM APPLIC7INT AMS TO COWII+LT WITH
NO P ASS. IAAS AND 7QZLTS OF TIM DTP )ON ' Alm OT
T SBAIL BE ISSCFD DRLFSS TM APPLICABLE TARS Alm 7QA.ES.
APPLICANT IDSS CIN FILE ALL INSORM CL (BOdDS) .
APPRovED FOR TSE caesD SSICI t BY: zy:! l 4 C 'D£P DA : 91,9 pot
DATE:
SMaTTE_
SIC>?>m 87C: ,1 ({tp 595. 3~os T
NYC-WTC 000111771
OCR can misread numbers and units. Confirm readings against the page image before using them.