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HomeMy WebLinkAboutResolution #528~ !t P, !^ R , r9V ~ •~ m n f't+ ~- R ,.^a w ! ~' .-~ r .., -l'~ - To t'°~e: "~::Da~-'o:~9M~N~ ~d~ ll"~C~eew;lc; E'T "~~ ay r?J4Y~,"? E:9°.+C ~IV~.r~....~"~ ~1.oc ,~ r~.,~ .t ~'+ ~ a . .': Mur,ici~ality ,-~_ Section .Art.:St. or State i-;uvy. , T I noreby recuest funds from the r~',unici~ality's allotment a~ Motor F uei Tax us i;er„i~e~ N4o~>>: CONSTRUCTION COSTS ------------------------------------------------- -------------- ENGINEERiNG COSTS ____________.______ -~ <. ADVEfzT1SING C~:STS ..----------------- RIGHT-OF-WAY COSTS (As ,oer itemization on reverse side) ____________ _ ----------------- S MAINTENANCE COSTS (Period from- to _ ~ TOTAL FUNDS REQUIRED ._-.__________--_________________ $ ~ ,, , ... . , Date ~'-- ~_ /~ Signed by _____ ~~"'-l%`~r ~~/,!~c«r~ .- ~~ ~ ~. (title of Official) _____ __ (Submit TWO copies !o the District Engineer) (Space below for District Engineer only) ---- .Ct:SOLUTIONS PASSED 19 RESOLUTIONS APPROVED 19 19 i 9- TOTAL lviONEY APPROPRIATED ESTIMAT'cD COST-Ccnst. (plus additions Engr. - - . _ minus deductions) R.O.W. •-. Maint. - . _ . TOTAL ----.. PAID TO DATE-Constr. - • • . $ Engr. - - - . . Maint. • . . TOTAL •-•-. $ BALANCE IN APPROPRIATION $ •lf contract section show contract costs instead of estimated cost. (7579f-15M--:-58~ APPP,OVAL RECOMMENDED lv District Engineer Porte BI'i.R 471