HomeMy WebLinkAbout66- Highway Commission of MT Easement
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STATE HIGHWAY COMMISSION OF MONTANA
HELENA
ENCROACHMENT APPLICATION AND PERMIT
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(Project Affected) (Maintenance Number)
APPLICA TION FOR PERMIT TO
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(Insert Nature of Permit)
1. Name of Applicant: City of Bozeman
2. Address of Applicant: City Hall, Bozeman, lllJ:ontt:~Im
3. If Applicant is a Corporation give State of incorporation and names of President and Secretary:
4. Nature of Permit desired: (Give sufficient detail to permit thorough understanding, and submit blueprints
or sketches, in triplicate, if desired by Engineer.) .
To const.rucL and install an 8 inch sanitar;y sewer line wit.h
aplmrtenant manholes on Highway right of ~ay. Beginnim~ at
a manhole at the int.ersection of dest Babcock Street. and the
~3outherly right of way line of Highway 191; thence southwesterl;y
parallel t.o and approximately 15 feet dis tant norther-l,r frout
the southerl;y right of way line of said HiGhway 191 8. distance
of 541 feet; thence southerly parallel to and 10 feet distant
westerly from the one-sixthteenth line of Section 11, T 2 South,
Hange i) E2,St to t.he south right of v:ay line of said Highway 19l.
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5. Highway survey stations at or near which installations or structures will be installed:
St.ation 357 + 00 to 364 + 00.
6. For how long a period is the permit desired:
7. REMARKS:
The sanitary sewer is proposed to be constructed and installed to
serve the Strozzi Subdivision in order to stop a seriously threatened
pollution problen,.
Dated at Boz eman , Montana, this 12th day of August ,1966
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'(INSTRUCTIONS CONCERNING USE OF THIS F'ORl\l)
Applicant will complete this form in triplicate and transmit it to the Division Engineer within whose division the high-
w,W affected is situated, Division Engineers will, if U1e applic:ation is for a minor encroachment, Le" installation of water,
sewer, approaches, gas, and irrigation pipe, ("tc" an.d if he approves applicCltion, sig.n permit form on reverse side hereof.
If application is for major encroachments, i.e., railro3.d crossings, attaching pipe lines to bridges, etc" the Division Engi-
neer will forward form in triplicate Ulrough District l';ngincC'r to thc Helena Office togetner with letter of transmittal giving
full information and recommendation, When application is approved and <lppJicant has signed acceptance, the original will be
delivered to him. If Permittee desires, he may sign acceptance at time of signing application.
RW 20
Rev. 11-';-59
PERMIT
CiI.llJject to the fo.Ll,)\1lne termG ,,-nd comHtlons, the permit "-pplied. f()r upon thE reverse olde hereof, is hereby grant~d:
1. Ib<~Rl\,r. This permit sha..l.l be in full force {:J,.::.tcl effect f'rom the date hert-~of rmtil revoked as herein p.rovided.
,-, RE1'l1L'AL. Rental Gil1l.11 be none.
;J. P..EVOCNllIon. This :permit T!1\J.Y be rcvo.~~,p.c1 by St...'l..te 'Upon e;iving 90 days days notice to Pennittce by ordinn,ry mall, d.i.TeGteu to
the ad(lret)::; sl1ow:n in. tl1e a.ppliu<:l.tion hereto n:l:,t!:J,.<.:i')ed, but tilG 3t:J..te rCSC1'ves the right to revoke this permit vTitt..ou.t givinn G<:dd. ilOl.;lcc,~ :1..11 the
~..:\\iC~nt h~rt::l.i l:.tCt":: hr'(>C1.~:s any of tho condi tlons or ter"ill3 set forth 'I,IE-~.r.ein.
)j . COFJ'<EnC~:.kF;F~ OF WORK. No "inrl-:: ah.all IJC COI!l!;lcncccl l.11l"~ll Fermi ttcc not i.L l(lf~ Divi~~lon ~nr;i.neE:'l' shown Ln appliG:1,.t,ton \:Thc.~n he: prapoG(.:I.l tC) cc.'mr,.lt:I'I.c.:C
1.'J()rk.
5. Ci,\A.rt-E:3 II; iU(}f.MAY. .if State Cn.1.11f.:jGS highHtl,Y l1CCCGsi tatln[: Clla1i.LC:s in Gtr'uct"\.l..I'l":fl Dr inst::J,.11ationo :Lnatalled uncl~r tt\is permit, Fermittee
shD.ll ma~~c necessar~I Cf.l.a.nges vli thout. cxpenr;e to Sta.te.
u. iyrATE SAVED HA.RHLB:-]S FROM CLAIMS. In '<.3.cceptlng thitJ permit the Permittee} itnjhit1 SUCCC::H.iOrS ar ~:I,f.l~>if~ns, :,,'j,gl;'t:.e to protect the Stu.to and
save it l1o..rmless from all claims} act,io:n~ or eJ.;::J..nll'ig8 01" CVf.~ry l:ind !::t.Y1d, dCtlcription which Tl1B.J accrue to, or be ,:nli'f'cred -oy} any peX'GOH or
pcraons} corporations or property by rCD.Gon or the perfoTIllal1ce of any SUGll HOyt:, oharacter of llk'l,t.cria,ls 'Used" Ot" :manncr of inE.:tCl.ll,],. tIn:nG,
maintonancE: a.riel oper~:I,tio.nj or by tho impr(")pcr occupanuy at' said hiC;J.1'day right o:f way} :::~11d. in c:~~sc any f>uit or act,I~O{l is orough't ar::o..i,I\nt t.!1C
Sta:te and !"J.ri~~lng out o.f." or by ;reason of, LUly of the 8.'Jove c,,l.u$es, the P~rmittee" its/hiD ~jUcccssorn or assigIH.l." 'ilill, upon not:\_cE-: to it/him
of ~Jhe comrilencement of such action} uGf'cnd the same at its/his Dole cost and expeDse and satinfy any Judgment vll:d.ch n1:::1Y be y,"endcrcd :.J,.eo.ins l:.
the S'ta te in arry such suitor "otlon.
7. PH.OIIIECTIO:N 014' Il'RAFFIC. Inaofar as the interest.8 of' the st~te and the traveling public are CODCE:rned." all \voT'k 'Pert'ormed rmdcl' tl.lit:. pc:rm-.Lt
shall. be done lUlder the supervision of' the Division Engineer of tht~ State Iiighw8.;Y COTflr:1:L~t;lon clond his authorized represento.tivet,-" an,cl he/they
shall imHcate barriers to be erected, the lighting thereof at niGht, pla.cing of flagmen and wa'tcI)lllen, manner in >Thiell traffic hI to be
handled" c::l,nd slk'l.ll Gpecify to Permit.tee hot" road surface is to be replaced if' it is dlst,urbed. during c)pera.tion~." but said supcrvicd_on s11;:1.11
in no way operate to relieve or cliflc'harce Permittee from any of the o.bligations asnumed by acceptance of this permIt, o,nd Gspccin.lly those
set forth under Section 6 hereof.
8. HIGfjWAY DRAINAGE. Tef the ,;ark done under this permit interferes in any ,;ay with the draina.ge of the State high>Ta.y affected, Permittee sh;dl,
at itS/his owr\. expense) rnrike such provisionG as the Sta,te may direct to ta~':e Gare of said dr{,iinage.
y. RUBBISH AJlD DEBRIS. Upon complcti{,1I1 of wor}c contomplatecl u.Ildor t11:\_G permit) <,.d.l rubbish and debris shall be immediately removed and tl:!.~
roadway c,3..nd roadsid,e Jeft in a.. neat and presentable condition t:.atisfactory to the State.
10. WORK TO BE SUPEHVISFJ) BY STATE. All ,;ark C)on'templ"tell lmeler thb permit 0",,-11 be done under the Bupervbion of and 1.0 Uw, "atlsfaction OI'
the authorized representative of the [)"tatc." <..incl the uta.te hereby reserves the right to order the chansc of location or removal of an'J.'
~;tructu.re or inst.all/::!,tion authorized by thLJ perrni t a,t any timt:" ~~aid cl1'J.nges or removal to be :walle at the sole eXpe!lSe of the Permittee.
11. STI\.TJ:.;'S RIGHT I'JOT TO BE INTERF.l:!U{E::D WITH. All such c,h'J.nges} rcconstructine; or relocation shall be done by Permittee in such n. manner o.s
\,ji11 cause tlle least interference 'W'lth any of the Sto.te 'e wor};., and the Gt.sI.te sh:.1.11 in nO wise be liable fo:!:' any dar:nage to the Permittee
by reason of "ny such work by 'the State, its agents, contractors or representatlves, or by the exercise of any rights by the State upon tile
~:tG~.Y vIlt:: .l.llbl.t<.A...l1.t;i....,:;"tDITF.('~'"'1!"turCE yln.c::rn"""'""UIfaer "tli!~'-.pcrm,l"'E-~.-'~-"--"-""'" -'- -.--
12. REMOVAL OF INS'1'ALIATTOlJS OR m'RUCTUJillS. Un.less ,;ai ved by the S'tate, upon tcrlllino<tlon of till" permit, the Permittee sh;;ll remove the
installa.tions or stru,ctures contemplated by thIs permit 1.:i.nd rcstoI"e tile prp.mi.::;es to the c..:oj.1di tion exis t ing tl,t. the ti.me of entering UpDIl
the same rmder this permi t, reason;.:~ble ,3..ncl ordinary wear and tear and c]l:I,.rI1':lbc l)y the clements} or by circumst"anceo over w.ni.ch the Perrnl ttcc
DiJ.S nO control." excepted.
13 . NIA.n:rr~HA.HC~E AT EXPElTG:G OF PERMITrt;E. Fermi ttee ~;hall mD,int~:t.ln, at its/his 301e E'::-:pcnsf.: the instc~llations awl strucbtr€s for wh;i.c:h this
permi t is L~anted, in a condi tion satiGfa(~tory to ""che St.ate.
14. 3TA1'E lIOT LIAI3ill FOR !lI\MI\.GE '1'0 IHSTALIA'l'iOH:3. In "Gcep-tinc thb permit the Permittee agreen that any damace or injury (.Lcme to said
instal1o,.tiotl::l or struct'\..lrcs by n. c;ont.ractor Harking for tho State, or by any State employee cng:1ged in con~,tructio[l." alt.erati.on." repair,
maintenance or improvement of tile ~3tatc l"JighHdY') 311-").11 be tl,t the nole cxpenne of" the n::I'1l:LL ttee.
J.5, STAT),] TO BE REIl11JUHi1ED FOR REPAlRIJ:G ROADHAY. Upon being billed ther~for Permittee agree" to promptly reimbursE' Sto.te for any expenfle
inc'\,l,1;"red ill rep!,:d.ring surfa.ce of rO;J.cl\.ray due to sett.lement a,t. inst.J.lla.tion} or fo:r any other damge to roodw8.y as a renu.l..t of the \,ror1:
performed cUlder this pe:r'mit.
16. OTJffiH CONDITIons AND/OR REl"L"cHK3.
All man holes shall be at ground level. Highway right-of-way will be left in as
good condition as found with proper compaction, etc.
D9.ted tl,t j I:lont<:i.tl.aj this dc'l,.y of ." 19
The undersi[9lcd, the ".p...ermittee.." mentia'.'"' ill ill, C"o- ~. ...-.... STATE .HIG.HW. AY COMMISSION.
going instru.ment} hereby accepts this permit." tocether / ----
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'P, By -<"~~ /
(".'.If .'J /_c;~,___, ("'_.'"'>' ",/.' Divisio.nEneineer
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State Highway Commission.
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Permi ttee I ,/ //. . Place)
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