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Long Term Occupancy Permit - Beacon Memorial Walsh Construction
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Long Term Occupancy Permit - Beacon Memorial Walsh Construction
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4/14/2025 2:16:35 PM
Creation date
12/12/2023 1:44:14 PM
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Board of Public Works
Document Type
Recommendations
Document Date
12/12/2023
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uTji <br />City of South Bend/Public Works <br />227 W. Jefferson Blvd <br />South Bend, IN 46601 <br />'--�� Application and Permit <br />Long Term Occupancy of City Right -of -Way <br />Applicant: Date: <br />Applicant Address: 7eB7 rl! .rl .ry-.-le .CIF .5:,,1,d Am 1, = .W G(o / <br />Project Site Address:1��,�,rr.1,it A1,k4a.1Z 4&r Al 414,901 <br />Note: Occupancy limited to street(s) immediately in front of construction site. <br />Nature and extent of Occupancy (e.g.: proposed construction activities, equipment proposed <br />to occupy public right-of-way, construction deliveries, etc.): <br />Z7� ,,,AA.y 4,14 el' /S <a & %i "g�'y %sf�icA �' �4tie.� � � a! ,�.� "05 w e-A <br />�! ✓A Z& C a ry ia. e.f 5-Ile <br />Duration of Occupancy: <br />Signature of Applicant: <br />THE TERMS AND PROVISIONS OF CHAPTER 6, ARTICLE 5 and CHAPTER 18, ARTICLE 7, Sec 18-62 OF THE <br />SOUTH BEND MUNICIPAL CODE ARE INCORPORATED HEREIN IN THEIR ENTIRETY. FAILURE TO COMPLY <br />WITH THESE PROVISIONS SHALL RESULT IN CANCELLATON OF THIS PERMIT. <br />THIS PERMIT SHALL BE CONDITIONED UPON THE EXECUTION AND FILING WITH THE BOARD OF PUBLIC <br />WORKS OF A BOND IN AN AMOUNT APPROVED BY THE BOARD OF PUBLIC WORKS, CONDITIONED TO <br />INDEMNIFY, SAVE AND KEEP HARMLESS THE CITY OF SOUTH BEND, INDIANA, FROM ANY AND ALL LOSS, <br />EXPENSE, COST OR LIABILITY OF ANY KINDS WHATSOEVER WHICH THE CITY MAY SUFFER OR BE PUT TO <br />FROM OR BY REASON OF ANY ACT OR THING DONE OR NEGLECT TO BE DONE, OR BY VIRTUE OF THE <br />AUTHORITY GIVEN IN SUCH PERMIT. <br />TO BE COMPLETED BY CITY STAFF ONLY: <br />Bond/Fee Amount: $ 2,740.00 Date Bond/Fee Filed: <br />❑ Compliance with CH 6, ART 5 and CHI 8, ART 7, Sec 18-62 of the South Bend Municipal Code <br />Fee Paid <br />Date Issued: <br />Issued By: <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />ta'k�a <br />Elizabeth A. Maradik, President <br />Joseph R. Molnar, Vice President <br />Gary A. Gilot, Member <br />Briana(/M� iicou, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: December 12, 2023 <br />
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