My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
Opening of Quotes - El Campito Water Tap Quote Proj No. 121-017 - Niezgodski Plumbing Inc.
sbend
>
Public
>
Public Works
>
Board of Works Documents
>
2021
>
Opening of Quotations/Proposals
>
Opening of Quotes - El Campito Water Tap Quote Proj No. 121-017 - Niezgodski Plumbing Inc.
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/9/2021 2:22:36 PM
Creation date
3/9/2021 2:18:15 PM
Metadata
Fields
Template:
Board of Public Works
Document Type
Projects
Document Date
3/9/2021
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
28
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
Show annotations
View images
View plain text
o SOUTH&' City of South Bend Public Works Phone: 574.235.9251 <br />Engineering Division <br />�.� Email: dhanson@sotrthbendrn.gov <br />. „ e 4227 W. Jefferson, County City Building 1316 <br />J!1. F, South Bend, IN 46601-1830 <br />7 <br />,x x, <br />1865 <br />TRAFFIC CONTROL, AND OCCUPANCYREQUEST <br />"SUBMIT 5 WORKING DAYS MINIMUM PRIOR TO PROJECT START DAVE <br />PLAN YOUR START DATE ACCORDINGLY TO AVOID DELAYS <br />Complete 1 - 5 Incomplete Submittals Cannon Be Processed <br />❑ Parking Lane ❑ Travel Lane ❑ Full Road Closure ❑ Alley ❑ Sidewalk Closure <br />2 ❑ Excavation/Boring? > Requires Excavation Form ❑ Construction? > Requires Curb Cut <br />application or sidewalk permit <br />4 <br />Submission Date: <br />Name: — <br />Phone #: <br />On -Site Contact: <br />Applicant/Company: <br />Email Address: <br />Office <br />Cell Contractor Performing Work: <br />Project STREET ADDRESS (eq. 1 10 W. Smith RD.): <br />Phone #: <br />Project Location (Block limits/Streets From and To): <br />Requested Start & End Dates: <br />Reason for Closure: <br />Requested Start & End Times: <br />Office <br />Cell <br />Affected Customers: <br />-- Contractors are responsible for resolving safety issues and access concerns with affected customers <br />ATTACH THE FOLLOWING ITEMS: 1. Traffic Control Plan 2. Detour Plan 3. Barricades, Signs, or Flashers Placement <br />(Refer to MUTCD for Traffic Control Device Requirements) <br />Failure to use traffic control for traffic restrictions or closures will result in stop work orders and/or delay in permitting. <br />5 THIS OCCUPANCY PERMIT REQUEST IS NON -TRANSFERABLE AND A SIGNATURE SUBJECTS THE NAMED CONTRACTOR/PERMITTEE <br />TO ALL APPLICABLE RULES, DUTIES AND OBLIGATIONS IMPOSED BY THE CITY OF SOUTH BEND MUNICIPAL CODE AND TO ALL <br />REGULATIONS IMPOSED BY THE SOUTH BEND BOARD OF PUBLIC WORKS. <br />Applicant Signature Date <br />ENGINEERING OFFICE USE ONLY: <br />❑ Approved <br />Comments: <br />❑ Approved as Noted ❑ Revise ❑ Not Approved <br />City of South Bend/Engineering Division Authorized Signature <br />Date: <br />Version 3.1 [10/24/20171 <br />
The URL can be used to link to this page
Your browser does not support the video tag.