Contract permit application for pavement work, Sept 2002

NYC 9/11 Public Portal Document

APPLTCA770N FOR CONTRACT PERMIT aaaction Control DO.1 (REV. 8-98) FRONT

CONTRACT #: D'F - R t Mi oy~J~ DNEC DBNEC DQEC DS?CEC DREC OCMC# )C DDOT ONYSDEC DNYSEDC DHPD DPARAS OSCA ONTA DPA of NTSNJ

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CONTRACT START DATE:_ CONTRACT CO)W ETION DATE: 9 l z!02. TYPE OF PAVE ENT: ROADimy: SIDERNM: TYPE OF PSEM T(S) REQUESTED (Check All Applicable): ❑111-ESA3OR INSTALLATION-SERER 0126-TEST PITS, COPES OR BORING CRANE/SHOVEL ON S T 0112-RAPID TRANSIT CONSTRUCTION D132-INSTALL EENC 0205-PLACE SHANTY/TRAIL ON 0113-REPAIR WATER 0135-ELI. RESTORATION STREET 0114-REPAIR SERER D136-DEP-MAJOR INSTALLATIONS- 0208-TEMPORARY PEDESTRIAN ELK 0115-REPAIR /SLI R .-LTER D211-TEMPORARY ROADWAY CLOSING 0116-FUEL OIL LINE O137-DEP-MAJOR INSTALLATIONS- 0214-PLACE CONTAINER ON STREET 0118-RESET,REPAIR OR REPLACE SERER D215-TEMPORARY SIDEWALK CLOSING CURB 0201-PLACE HATEur L ON S T 0401-REPAIR SIDE .IE 0119-PAVE STREET 0202-CROSSING SIDEWALK 0402-CONSTRUCT NEW SIDEA.LK 0120-TPXE PIT 0203-PLACE CRANE/SHOVEL ON 0403-REPLAC? SIDEWALK 0121-CONSTRUCL OR ALTER MANHOLE STREET " VENTILATORS AND/OR CASTING 0204-PLACE EQUIPMENT OTHER THAN OTHER FIFE OF PERT1T:

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SPEQIL STIPULATIONS

OCHC APPROVAL BY: DATE: ❑MORE LOCATIONS ON REVERSE THE PERMIT TO BE GRANTED SUBJECT TO TEE FOLLOWING CONDITIONS: THE APPLICANT AGREES TO COMPLY WITS ALL LAWS AND RULES OF THE DEPARTMENT AND OTHER APPLICABLE LAPS AND ROLE5. NO P T SHALL BE ISSUED UNLESS THE APPLICANT HAS ON FILE ALL INSURANCE(BONDS). .'

APPROVED FOR THE COMMISSIONER BY: SUBMITTED BY: DATE:

, DATE: SIGNED BY: /l - u _ __ TEL. # ( ) AUTEOAI--!.-' P_2..ESENTATLVE OF APPLICANT

NYC-WTC 000111865