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HomeMy WebLinkAbout65- Highway Commission of MT Easement .. -. .. ~ ~'.. -; ..;1-c=;f . ...;",.) /~. ,.<0 ". . RW 20 0~;:~::I~Zt:~:;~S~IO~ OF MONTANA HELENA ENCROACHMENT APPUCA TION AND PERMIT ____m________.__U~222.____.__ __ __ __ __ _m___._m_____m_____.m ~___________________________________________________________.__.__n______ (Project Affected) (Maintenance Number) APPLICA TION F'OH. PERMIT TO mm__ _.___G_g~___QK__~()_?!~~~_t:!_J _ M9_~_t ::l,D_~_ ____________ ___ .,__ __ m____ (Insert Nature of Permit) 1. Name of Applicant: City of BozemanJ Montana 2. Address of Applicant: 326 East MainJ BozemanJ Montana 3. If AppHcant 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 construct and install an 8" vitrified sanitary sewer and a manhole on Highway Right-of-way as shown on attached sketch. Sanitary sewer and Manhole to be approximately 13 feet deep. Manhole cover to be installed flush with Highway grade. 5. Highway survey stati.ons at or near which installations or structures will be installed: 23 + 16.4 6. For how long a period is the permit desired: Permanent 7. REMARKS: Dated at Bozeman , Montana, this 29th day of September ,1965 __J::XrL_OE.J~QZEMAJ.:L..___________ _ _n - -.- ....__.._-------------------_._----_._~ (~~~Roman c. Fa~i~ Engineer .,~~~~ c-,~-'-------- ------ - ---, S a ---- Applicant) (INSTRUCTIONS CONCERNING USE OF THIS FORM) Applicant will complete this form in triplicate and transmit it to the nivi:-;ion Engineer within whose division the high- WDy affected is situated. Division Engineers will, if the appJicaUon is for a minor encroachment, i.e., installation of water, sewer, approaches, gas, <lnd irrigation pipc, etc., and if he approves application, sign permit form on revcrse side hereof. If <lpplication is for major encroachments, i.e., raiJl'o:Jd CI'0;3s~ngs, <lttaching pipe lines to bridges, etc., the Division Engi. neeI' will forward form in triplicate through District Engincer to the Helena Office together with letter of transmittal giving full information and recommendation. When application i:-; appl'oved and applicant has signed acceptance, the original will be delivered to him. HPermittee desires, he may sign acceptance at time of signing application. ~ . 0- ... . . ...._~, ~--- ---\~.~ ~~'1-+T=~d ..' "",-- _' , (<~ ....;l_-- --:.=? t \ - - (-~'>> \--- - - '"/0<:'" J----=--<:- --~ - -- - -;. --.---:;,/ .--- - tl-; "\.'--\~ ) , , \" I ---' , ",--' "U01ss,=O 1:W\q:J'm "q.'l4S '//71/ /?';:!5(- (/~.-')(~OC};:1 J..- /1 '/ ~""u,~u~ UO,S,A,U 6~7Ku c_, C L-___~-~~~ " .'~ --_no :..___,~___.__._. -:=-::::-=- -- -. 'u1~~aq~ qq.~o.;): q.as SIIO,q. n'LLOO 'Put, S1!l.I';q. ~qq. .;):0 11'13 qq. 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