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CITY OF GLENDALE APPLICATION FOR PERMIT TO PERFORM WORK ON PUBLIC RIGHT-OF-WAY CONSTRUCTION ENGINEERING DIVISION N2 1217 8 EPsp[T ��' PPROJECT NAME:ERMIT NO: ///��� �I,/�py�/}�/�� f/ ! / DATE ISSUED: -, rThicie)o- PROJECT ADDRESS Y 1- /`0 t�i - l DATE EXPIRES: - QUARTER SECTIONl _ DATE ACCEPTED: r�.rA.td.�,11 l,C�dwM P(D • 4) '11 �h i.. /it__ gSCbO hactar //I�Z� Address tractors License No. /ej to (//ly�J�O'DDaytimePhPMre •..Wyr(1�7 (�224.FIourEmmerrrnccy PhoneAbhieiPa0er Phone (7c.)-()i Ia(..Ccondi set forth on the revsasaside Vof 1 aid understand a�© the must bad ca, - with the laws of Mer? codak.aid the State of uOot— o1/ Appicant's Nemo • / -=7 S ., -A07--' x e - �p.��(M'y^'��I/� ni�tW (iv uz VIP. ( 07 (fire -51 �y, _Pi ,Az i5n19 WATERLINES "" ! LF 2...".Dia. LF Dia. SANITARY SEWER LF Dia LF _Dia. MISC _ EA Manholes LF Dia. LF Die. ALF D'q LF _Dis. EA Fee Hydrants IiFurance / , ❑ Cash Bond Amount Narne/AdQess of person to return bond la'. Mince I rte/❑�Su�rety Nwixr . L4 Issued• A,/)1/2 - C4mmenls: Q . UTILITY PERMIT FEE UTILITY PERMITS UNIT PRICE i BASE FEE $ 50.00 TRENCH(RAM PAVED LF $015Lf $ TRENCH(RMI)UNPAVED • 150.10 AF $ PITS - it EA @;$t0.00IEA $ STREET LIGHTS EA $50.00IPOLE $ • TOTAL: $ STREET PERMIT FEE STREET IMPROVEMENT PERMITS QUANTITY :::.UNIT PRICE BASE FEE $ 50.00 PAVING 'SY• @ $030/EY $ MANHOLES f _.. EA • @,$40001EA $J: CURBS GUTTER LF g-$0.20tLF $ VALLEY GUTTER SF _;.4 S0.0B/SF $ SIDEWALK SF @ Elms/SF $ SIDEWALK RAMPS SF @ $0.10/SF $ PRIVATE RESIDENTIAL DRIVEWAY EA @ $25.00/EA $ DRIVEWAY SF @ $0.10/SF 5 CURB CUT EA @ $200.00/EA $• CATCH BASIN EA @ $40.00/EA $ TOTAL: $ 2 30 WIS PERMIT FEE WATER/SEWER I STORM DRAIN PERMITS QUANTITY UNIT PRICE BASE FEE @ 50.80 Ls S r� '5$ 50.00 ^ WATERLINE IF 5jrO `f^'�5�"rF./ `/ - NJ SEWER LINE LF @ $0.60 AS $ V STORMDRAIN LF @ $10OAF $ p0 • IRRIGATION LF @ $1.00 A.F $ MANHOLES EA @ 540.00/EA $ WET TAPS / EA @ $300.00/EA $ al TOTAL: TOTAL PERMITT FEE: 5/01