NYC 9/11 Public Portal Document
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CONTRACT START DATE: Q (02. nn
51 2 CONTEZACT CONPIETION DATE: 7I2 5 02
TYPE OF PAVEMENT: ROADWAY- SIDEWALK
TM: OF PEP tT(S) REQUESTED (Check All Applicable) :
D111-MAJOR INSTALLATION-51' 0126-TEST PITS, CORES OR BORING CRANE/SHOVEL ON STREET
0112-RAPID TRANSIT CONSTRUCTION 0132-INSTALS. FENCE ❑205-PLACE SHANTY/TRAILER ON
❑113-REPAIR WAFER D135-FIlAL RESTORATION STREET
0114-REPAIR SEW 0136-DEP-MAJOR INSTALLATIONS- 02O8-TElMORARY PEDESTRIAN STALK
N0115-REPhIR iATER/S W 0211-TEMPORARY ROADWAY CLOSING
0116-FUEL OIL LINE 0137-DEP-2JOR INSTALLATIONS- 0214-PLACE CONTAINER ON STREET
b118-RESET,REPAII2 OR RYT.ACE SLNMR ❑215-TEMPORARY STr+ETh.rx CLOSING
CURB 0201-PLACE MATERIAL ON STREET 0401-REPAIR SIDEWALK
119-PAVE STREET 0202-CROSSING SIDEWALK 0402-CONSTRUCT NEW SIDEWALK
0120-TREE PIT 0203-PLACE CRANE/SHOVEL ON ❑403-REPLACE SIDEWALK
'0121-CONSTRUCT OR ALTER MANHOLE STREET VENTILATORS
AND/OR CASTING 0204-PLACE EQUIPMENT OTHER THAN
OTHER TYPE OF PEMaT:
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SPECIAL
OCE APPROVAL BY: DATE: ❑MORE LOCATIONS ON REVERSE
TBM PERMIT TO BE GRANTED SUBJECT TO TEE FOLLO'AING ODNDITIOl(S:
THE APPLICANT AGREES TO COMPLY WITH ALL LAMS AND RULES OF THE DEPARTMENm AND OTHER APPLICABLE,LAPS AND RULES,
NO PERT SHALL BE ISSUED UNLESS THE APPLICANT HAS ON FILE ALL INSURANCE(BONDS).
APPROVED FOR THE CONHIISSIONER BY: SUBMITTED BY: DATE:
DATE: SIGNED BY: . 1 ' CL TEL. ff
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AG'TEORIZED REPRESENTATIVE OF APPLICANT
NYC-WTC 000111849
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