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HomeMy WebLinkAbout67- State Highway Encroachment Application and Permit for Sanitary Sewer :1 ~ :1?, , . > . . . . RW 20 STATE HIGHWAY COMMISSION OF MONTANA , HELENA ENCROACHMENT APPLICATION AND PERMIT ______lL!_~.~__J9J:__ F. ll.!_p_!___.f=i?_Ql_J:Z) _n _-.."._________.._____.,____. . .___..,. . . _. _..__~.. _,.,..~ (Project Affected) (Maint.enance Number) APPLICA TJON FOn PERMIT 'TO Con:;;t rQct . and. InstalLBanitar}'mSewer. __ um (Insert Nature of Permit) 1. Name of Applicant: City of Bozeman, Montana 2. Address of Applicant: City Ha1l., 411 East Main Street, Bozeman, Montana q If Applicant is a Corporation give State of incorporation and names of President and Secretary: ~-). 4. Nature of Permit desired: (Give ~;llfficiellt detail to permit thorou,gh understanding, and submit blueprints or sketches, in triplicate, if desired by Engineer.) To construct and install an eight (8) inch Vitrified Tile Sanitary Sewer line to serve a portion of that area of the City lying South of Main Street (U.S. 191, Federal Aid Project No. F-203-(7) and easterly of station 386 + 82.8 C 15th Avenue. Sanitary sewer to be constructed will begin at the Manhole 50 feet South of centerline opposite station 386 + 69.7 and extend easterly a distance of 210.4 feet to a point which is 46.75 feet southerly of centerline station 388 + 60.1 as shown on t.he attached sketch. D. Highway survey stations at or near which installations or structures will be installed: 386 + 69.7 to 388+80.1 G. For how long a period is the permit desired: Indefinite 7. nEMARKS: Dated at Bozeman , Montana, this 5th day of July ,1$7 CITY OF BOZFMAN _~__~_~~_~~~_.~'__~__________________________________. _....____. .... _... ., u_____,...,.. .,.,_ ~21t __________~r~ __ " __ ______ .,."" ------------------------ --..----- City Manger ture of Applicant) (INSTRUCTIONS CONCERNING USE OF THIS I~ORM) Applicant will complete thi:; form in triplicate ,mil rr:msmit it to UlE' llIv.ision Engineer within whose div.ision the high- Wi'Y affected is situated. Division E:lIgineel'c', will, H Hie applicati.on is for ,1 minor encron clmH'1I 1., I.e., instnllalioll of water, sewC!', <Jppl'Oactles, gas, oncl irri,:pl lion pipe, etc., ; md i C )1(' ;:P1)1'oVCS application, sign permit form on reverse side hereof. If application is for major encroachrnents, Le" raLI,null Cl'o:;."ings, 8ttachillg' pipe lines to bridge;;, etc., till' Divi:;ion Rngi. 1.leel' w.ilJ forward fOl'min tl'ipliGlte Ultongh ni.,II'iCl, T~llgineer to the Helt'nl.l. Ufficz' togeUler with letter of transmittal giving full information and recommendation. Vlhell application is dppl'oved :md ri)!p1ieant h:1S siglled acceptance, 1.lw origillol will be delivered 1.0 him. If Permittee desires, he may sign acceptalj(>~ at time of signing application. , , . ~ '')' (""1]Td). .... "". ""n1ill.Wd ___m /'~jp';:_~" .._-~ ? r v ~ tJ . UOT~:;:~;TU1llioJ /~'~1-'l\.1~:~in:. ~~+ 'fq.~:; _~w~,,__~~",'~'_'_' -,'~-~._--~~.,",.- .I;:.);..~l["~~)Uq nOT sT i~T(j ._-,~---"~. . .-~ r::::yr:a - (/y~ ."..~ '''1''''''1['1- l!1.1OJ 'pc 8UOT'1-nmo:J pUIC sm,JC4 'YJl ,,0 IT" "Xi" . ,p"".' " . ,,,,/ .r')T.{'..j.;:IIh.q (+ 1w...:tc:::~d" Q '~q'l Wld,J;l:ni Aq ;:,X:)Tl {'.:).l.,;")la,(~.l1 srI",!" 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