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vw <br />City of South Bend Public Works Phone: 574,23S.9251 <br />Engineering Divi ion <br />4227 W. Jefferson, Cmnly Illy 5vilerng 1' 316 Email, d[)ansorAa)soUihbend1n.gov <br />Sotllh Bend, IN 4U/JI-I830 <br />TRAFFIC CONYROL AND 0CCUfA!yCYRCQUEST <br />"SUBMIT 5 WORKING D,AYS MINIMUM PRIORTO PROJECT START DATE <br />PLAN YOUR START DATE ACCORDINGLY TO AVOID DELAYS <br />Coinplefe I - 5 Incomplete Submiffals Cannot Be Processed <br />.1 Parking Lane Travel Lane Full Road Closure Alley Sidewalk Closure <br />2 Construction? > Requires Curb Cut <br />Excovall Ion/ Boring? > Requires Excovatlon Form 7 ­—;t <br />Submission Date: 1/16/2018 Applicant/Company: KRG Eddy Street Land 11, LLC <br />Narne: Tony Halsey Email Address: thalsey@kItereaIty.corn <br />Phone -9: (317) 7113-5663 0"Ice TBD <br />call Contractor Performing Work: <br />3 <br />TBD TOO (31fice On -Site Contact: Phone It: rall <br />Project STREET ADDRESS (eg: 110 W. SmIth RD.): 1055-1145 N, Eddy Street, <br />Project Location fBIock limlis/Streets From and Tod: s"A"a"t ';4"V'4f1 "aWouvl air aliqV."At w kvij <br />Requested Start & End Dates: Mmrch2018-0dobar20'I9 Requested Starl & End Times: S13 standard times <br />Reason for Closure: �Construofion of Phase 11 of Eddy Street Commons <br />4 ............. .......... . <br />Affected Customers: 1006 East St, Vinoent Street, 1020 N. Frances Street, '1018 N. Frances Street <br />- con4cu'-tors crrp responsib;p for rpsofvIng safefy ksons oncl access concerns witty (.Vfpc Ietq cusk)"IIPI'S <br />ATTACH VIE FOLLOWING ITEMS, I . Troffic Control plan 2. Defour Plan 3. Rarricadas, Signs, or Flashers Placemeni <br />(Rater to MUTCD for Traffic Control Device Requirements) <br />Failure to use Itaffic control for traffic restrictions of closvres, will result In stop wotl( orders and/or delay In permitting. <br />THIS OCCUPANCY PERMIT REQUEST IS NON -TRANSFERABLE AND A SIGNATURE SUBJECT$ THE NAMED CONTRACTO,R/'PERMIT7EE <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 />T qzz't� <br />Applicant Signature 114dttilo Date 1// <br />%f U <br />ENGINEERING OFFICE USE ONLY: <br />1:1 Approved 1:1 Approved as Noted Revise Not Approved <br />City of South Bend/Engineering Division Authorized, Signature Date: <br />Version 3.1 [10/24120171 <br />