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r AMIAL CWSTRUCTIOM . Uhmit pclnt •howing ffp% mni I.Mflon o9 Inttallgtlgu. <br />3. UNDERGROUND COMSTRUCTIOM <br />CONDUIT INSTALLATION <br />□ Multi duct tilu P!p« clots <br />□ Trontito Typo boddtog. <br />□ Cloy or concroto Sorvico typo _________________ <br />□ Stool, cost or plastic Siso Ti/C**_________ <br />OtHor______________________________ Dopth ___________ <br />4. METHOD OF INSTALLING UNDER ROADBEDS (If opon troocK osplolfi «rky nocossory) <br />Q Soring □ Jodiing □ Opon trondi <br />AREA TO BE DISTURBED <br />Ig.4LYgLEDSURFA« <br />Q Concroto <br />□ Bituminous <br />Othor _____________ <br />w SHOULDER <br />□ Bituminous <br />□ Grouol <br />Othor _____ <br />I BOULEVARD <br />□ Sod <br />□ Fiold Gross <br />Othor. travel <br />STRUCTURES <br />□ Bridge <br />□ Bom culvort <br />□ Pipo (Concroto, metoi) <br />Q Curb B Gutter <br />□ Sidowolk <br />Othor________ <br />□ Trees <br />□ Shrubs <br />Q Plontings <br />W' <br />6. The surfoco will bo restored ond oil work under this permit will bo completed on or before __ i ecc!!!»>or 31^ l‘>76 <br />(PERMIT IS VOID AFTER TNIS DATE) <br />If work connet bo completed within dotes specified, o written request for permission of estensien must bo ssodo to the Hennepin <br />County Highwoy'Deportment. <br />EMcept for the negligent octs of the County, its ogents and its employees, the Utility or Permittee shell assume oil liobillty for ond <br />save the County, its ogents and its employees, harmless from any ond oil claims for domoges, octiens or couses of octien arising <br />out of the work to be done herein ond the continuing uses by the Permittee, including but not limited to the placing, constructing* <br />reconstructing, mointoining ond using of sold utility under this opplicotion ond Permit for construction. <br />(I, We) the undersigned, herewith occept the terms ond cortditions of the regulations os laid down by the County of Hennepin or»d <br />ogiee to fully comply therewith to the sotisfoction of the County Highwoy Deportment. <br />Orgonisotion .Ml (XS CQMIXIY <br />J.:i. Aritjerson, Oiief ’’ni:inecr