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e <br />BOARD OF PUBLIC WORKS <br />AGENDA ITEM REQUEST FORM <br />Please Submit Agenda Item in Signed, Original Format <br />Please Complete All Applicable Sections of Form <br />Date: <br />11/22/05 <br />From: <br />Nick Witwer <br />Department: <br />CED <br />Phone: <br />5836 <br />Type of Agenda Item (drop down list): <br />Other <br />For Board of Works Meeting: <br />11/28/05 <br />Contractor/Consultant Name: <br />The Abonmarche Group <br />Project Name <br />U.S. 31 Industrial <br />Project Number <br />Park ... Replat Deed of <br />Dedication. <br />Purpose/Description: <br />Amount of Contract/Agreement: <br />• Funding Source <br />Change Orders - Increase/Decrease: (please <br />check one) <br />• Amount of ❑Increase ❑Decrease: <br />• Total Percent of Increase/Decrease: <br />• Original Contract/Project Amount: <br />• New Contract/Project Amount: <br />• Funding Source: <br />To Dedicate the right of way <br />of Stub street located in <br />U.S. 31 Industrial Park. <br />❑ Increase ❑ Decrease <br />Note: For Questions, Please Contact Board of Public Works at 235-9253 <br />