HomeMy WebLinkAbout57- Highway Commission of Montana Easement
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Form No. 73
::lM ~J-54 66017
STATE HIGHWAY COMMISSION OF MONTANA
HELENA
ENCROACHMENT APPLICATION AND PERMIT
.f_._AJl__e_L__:L~~_._____L~_2 0 ~ ~__(J21______
(Project Affected)
(MaIntenance Number)
APPLICATION FOR PERMIT TO
W t\'iJ,'fi 8 I R'~; h) ..,. U,; i 1
(Insert Nature of Permit)
1. Name of Applicant:
'~;IlTY :;l~ S~)2' r:t~\~
'? Address of Applicant: C 1 ty rlall. !30~f,man, )ion tana
3. If Applicant is a Corporation give State of incorporation and names or Pre~iidenL and Secretary:
A munIcipal oorporation of thf! 3ta te of ~;,ontEl na, in G~, n st! 1'1 \.:ounty
Arnol() Vi. >:)wan80n,;'~a.yor; L. I]. Shadoan., .:;lerk of the (;1ty
C ommIs8 1 on
4. Nature of Permit desired: (Give sufficient detail to permit thorough lmclen~tanding, ::md submit blueprints
or sketches, in triplicate, if desired by gngineer.)
A permi t to 0 ross II .~;. nlghwwy No.. 191 (Vvest Us. in Street extended)
wi tr iii. 14-1 neh OQ8 t iron pir.e we ter matn, 25 feet ea at 01' the wes t
line of the SR~ NW.}, Seotion 12, '1' 2 S, E 5 F, ?,"OllJ, (l<'ifteent:h
Avm ue extend ad) ..
5. Highway survey stations at or near which installations 01' structures will be installed:
At or near ciuI'vey Stl:Jtlon 387 + 10 on F.A.P. No. r.-20~-(5)
6. For how long a period is the permit desired:
Forever
7. REMARKS:
Dated at
Bozeman
, Montana, this
26th
day of
.Llly
1957
,
CI'.iY 'IF P"\Z JIlA!;
mm~tGS~icani)
.\1ayor
(INSTRUCTIONS CONCERN1NG lJSE OF THIR :FORM)
Applicant will complete this form in triplicate and transmit it to the Division Engineer within whose division the high-
way affected is situated. Division Engineers will, if the application is for a minor encroachment, i.e" installation of wCloter,
sewer, approaches, gas, and irrigation pipe, etc., ami if he approves application, sign permit form on reverse side hereof. If
application is for major encroachments, Le" railroad crossings, attaching pipe lines to bl'ldf-';es, etc., tl10 Di vision Engineer
will forward form il'l 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 delivered to him. If Permit-
tee desires, he may sign acceptance at time of signing application.