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Home My WebLink About57- Water Main Crossing, Encroachment Application ,.. ,.,... . \ " Form No. 73 1JM 9-54 G60l7 STATE HIGHWAY COMMISSION OF MONTANA HELENA ENCROACHMENT APPUCA nON AND PERMIT ._.__.__E_!}1__!._:~-,,-____~~Q_~.__J_1~____ ,,",,_________ (Project Affected) (Maintenance Number) APPLICATION FOR PERMIT TO . .______________~~~1_IJ11~~___. ~\,~' 1\. I. ~~ CR;~'_~SSI_1\'U (Insert Nature of Permit) 1. Name of Applicant: GITY)F B') ZE.~,:Al~ '} Addrpss of Arrli('~nt7 r: 1 ty F.-911;. P(')!l eml'-ll'l.. --3tor;ton!l 3. If Applicant is a Corporation give State of incorporation and name:3 or President and Secretary: A municipal eorporsttrJ1} of' tr-e State ('If ontana, tn :iullat1n County Arnold co. Swanson, c.!ayor; L. G. Shadoan, (..:lel"k of the Clt:V :;ornmlaslon 4. Nature of Permit desired: (Give sufficient detail to permit thorough understanding, and submit blueprints or sketches, in triplicate, if desired by Engineer.) A :'ermit to crossj';ortt, Seventh IlvE'\nue, ~ tl;e i';tty of _o~:elJ12(', with a 10..'noh oast iron p1pe water maIn, 20 feet sout}) of the north nror,:- erty It ne on ~~e8t Eeall Street (ea gt of Seven tb Aventl ~). 5. Highway survey stations at or near which installations or structures will be installed: At or ~ar ....urvey Station 2 + 45.0 on F.A.? No. 179 6. For how long a period is the permit desired: i'orever 7. REMARKS: Dated at L'02eman 26th .Ju'Y , Montana, this 19b7 , day of .. C TTY 'i !:":)')/.'!iP.' 1\.,\ c;?'~~4Q~m Ah~~)rD v. SvvI\N~>")N'SignatureofApp!icant) "~Byor (INSTRUCTIONS CONCERNING USI!] OF THIS FORM) Applicant will complete this form in t.riplieate and transmit it to the Division I{;ngineer within whose division the Iligll- way affected is situated. Division Engineers will, if the application is for a minor encroachment, i.c., installation of water, sewer, approaches, gas, and irrigation pipe, etc., and if he approves application, sign permit form on reverse side hereof. If application is for major encroachments, Le., railroad crossings, att.aching pipe Iincs to bridges, etc., the Division Engineer will forward form in triplicate to the Helena Office together with letter of transmittal giving full information and recommen- dations. When application is approved and applicant has signed acceptance, the original will be delivereej to him. If Permit- tee desires, he may sign acceptance at time of signing application. .. .. . ""'- . .\ 'I PERMIT Subject to the following tel'lns and condItions, the permIt applied for upon the reverse side hereof, is hereby granted: 1. 'i'li:RM. 'l'his permit shall be In full force and effect from lhe date hereof until revoked as herein provided. 2. RENTAL. Rental shall be 3. REVOCATION. This permit may be revoked hy State upon giving days notice to Permittee by ordinary mail, directed to the address shown in the application hereto atiached, hut t.he St.ate reserves the right to revoke this permit without giving said not.ice in the event Permit.tee breaks any of t.he conditions or terms set forth herein. 4. COMM]]jNCEMENT OF WORK. No work shall be commenced until Permittee notifies Division Engineer shown in application when he proposes to commence work. 5. CHANGES IN HIGHWAY. If State changes highway necessit.ating changes in structures or inst.allations installed under thIs permit, Permittee shall make necessary changes without expense to State. 6. STATE SAVED HARMLESS FROM CLAIMS. In accepting this permit the Permittee, Its/his successors or assigns, agree to protect the State and save it. harmless from all claims. actions or damage of every kind and description whIch may accrue to. or be suffered by, any person 01' perf;on~, cOl'poration~ or property by reason of the perfol"HHlnrp. of. any ~u~h \~iork) eharnnter of "materlals ll~(l'd, or rnnnnp.'t" ()f insl',nllnt.1o:n~t rnaintcnal1Cc and operation, Ol~ by thH irnpI'Opel' occupancy of said highway right of wny~ and in ease any Su.lt or netion if; broug-ht against the State and n:eh.::ing out of, 01' l)y reason of, an,y of t.he nhove causes, the Permittee, its/h'is suceessors or aS~3igns:l wUl, upon notice to it/him of the commenccment of such action, defend the sallle at IlS/hls sole cost and expense and satisfy any Judgment wllichmay be rendered against the State In any such suIt or action. 7. PROTJ<~CTION OF TRAFFIC. Insofar as the interests of the State and t.he travellng public are concerned, all work performed under this permit shall be done Ul.1del' the supervision of the Division Engineer of the Slate Highway Commission and his authorized representatlves, and he/they shedi indicate bal'l'ler" to be erected. the light.ing thel'eof at night, placing of flagmen and watchmen, manner in whid1 traffic is to be hanelled, aIlel sl1(,ll Slwcify to Permittee how roael sUTface is to be rcplaced if It is disturbed during operations, hut said supervision shall in no way opel'" ate to relieve 01' discharge Permittee from any of the obllgations assumed by acceptance of this permit, and espeCially those set forth under Section f) hereof. 8. HIGHWAY DRAINAGE. If the work done under thIs permit interferes in any way with the drainage of the State hIghway affected, Permittee shall, at its/his own expense, mal;:e such provisions as the State may direct to take care of said drainage. 9. RUBBISH AND DEBRIS. Upon completion of work contemplated under this permit, all rUbbish and debris shall be immediately removed and the roadway and roadside left in a neat and presentable condition satisfactory to the State. 10. WOnK TO BE SUPEnVlSliJD BY STATE. All work contemplated under this permIt shall be done under the supervision of and to the satisfac" tion of the authorized representative of the State, and the State hcreby reServes the right to order the change of location or removal of any structure or installation authorized by this permit aL any time, said changes 01' removal to be made at the sole expense of the Permittee. 11. STATE'S RIGHT NOT TO BE INTERFERli:D WITH. All such changes, reconstructing Or relocation shaH be done by Permittee in such a man- ner as will cause the least interfcrenee wIth any of the State's worK and the State shall in no wi:;e be liable for any elamage to the Permittee by reason of any such worl;; by the State, Its 1lgent.s, contractors Or representatives, or by the exercIse of 1lny rights by the State upon the highways by the installations or structures placed under this permit. 12. .. 0 r' ) 1:{. ,.. ,. li 14. fi 1:'1 [-, U) . 1 15. ') 0 t I ,-' ,- Rl<JMOV AL OF INSTALLATIONS OR s-rnUCTURES. Unless waived by the State, upon termInatIon of this permit, the Permittee shall remove the install1ltions or structures contemplated by this permit and restore the premises to the condition exIsting at the time of entering upon the same under thIs permit, reasonable and ordinary wear and tear and damage by the clements, or by circuIIlstances over which the Permittec has nO control, excepted. MAINTl'JNANCE AT F.;XPENSE OF PlCRMlTTEE. Permittee sllali maintain, at Its/hIs sole expense the installations and structures for which this permit Is granted, in a condition satlsfactory to the State. STATE NOT 1,IABLE FOR DAMAGE '1'0 INSTALLATIONS. In accepting thIs permit the Pcrlniltee agrees that any (lam1lge 0\' injury done to said installations or struetures by a contractor working for the State, or by any State employee engageel in construction, aiteratIon, repair, maintenance 01' improvement of the State highway, shall be at the sole expense of the PermIttee. STATE '1'0 DE RlCE\lBURSED l"OR REPAIRING ROADWAY. Upon being billed therefor Permittee agrees to promptly reimburse St1lte for any expense incurrerl in repairing surface of roadway due to settiement at installatIon, or for any other eIamage to roadway as a result of the work performed under this permit. li 1'.'1 . If). C,: OTHER CONDlTIONS AND/OR REMARKS. i r] ,.:j ~> i 'I ~~i ~, , : - ::.Ll ; 1.~; p" I"i ",") t:,. Dated at ,Montana, this day of ,19 GIN OF BOZEMAN .d~4~~~~~~ Permittee ARNOLD ~l[. SWANSON, N,s.y(")t' STATE HIGHWAY COMMISSION .k: ~... ......~ By _______:__~:~:__~~.~~~____::_~~/-." ,.,:~?J..~~ '___,=-__ ~ ~ 1 , OiviRion Engineer . St1l!.e Highway Commission. The undersigned, the "Permittee" mentioned in t.he fore- going instrument, hereby accepts this permit, together with all of the terms and conditions set forth therein. ( Plaee)