L-14829
lllinois
Department
of
Translrortation
Whereas,
I
(We)
City
of
Momence
Highway Permit
District
Serial
No.
600
WWater
Street
(Name of Applicant)
(Mailing Address)
Momence
lL
60954
hereinafter termed the Applicant,
(city)
(State)
request
permission and authority to do certain
work
herein described on
the
right-of-way of
the State
Highway
known
as
lL
Route
1117
,
Section
from
Station
Kankakee
to
Station
LOCATED
AT
NORTH STREET AND
AT
315 NDIXIE HIGHWAY
Upon approval
this
permit authorizes
the
applicant
to
locate, construct,
operate
and maintain at the
above
mentioned
location,
water
main and sewer
sink
hole repairs as shown on the
attached
plans
which
become a part hereof.
The
applicant
shall
notify Harold
Mays,
Field
Engineer,
Phone:
815-933-7532 or
theDistrict
Permit
Section,
Phone:
8'15-
434-8490
twenty-four
hours
in
advance of starting any
work covered
by
this
permit.
The state
right of
way shall
be
left
in good
condition.
(No
advertising
matter shall be placed on the
state
right
of
way).
All
turf
areas
which
are disturbed during
the
course of this
work
shall be restored to the
original
line and grade and
be
promptly
seeded
in accordance
with
Standard
State
Specifications.
(sEE
ATTACHED SPECIAL
PROVTSTONS)
All
work
authorized by
this
permit shall be
completed
180
days
after the date this
permit
is
approved,
otherwise
the permit
becomes null and void.
This permit
is
subject to the
conditions
and
restrictions
printed on the
reverse
side of
this
sheet.
County. The
work
is
described
in detail on
the attached
plan or sketch
andior
as follows:
This
permit is hereby accepted
and
its provisions agreed to this
Witness
Signed
Mailing Address
Mailino Address
't\\OmExlc€
tL
City
State
City
State
SIGN
AND
RETURN TO:
Approved
this
Regional Engineer
day
of
Department
of
Transportation
BY:
Deputy Director of Highways, Regional Engineer
Printed
10/2912015
OPER
1045
(Rev.08l07l
