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ROAD BORE APPLICATION

 

Please complete the following application and mail, email or fax to:

East Union Township Trustees                   Email:  Eastuniontwp@yahoo.com

              PO Box 222                                                            Fax    :  330-698-7723

Apple Creek, Ohio 44606

SEND A FEE OF $50.00 WITH THE APPLICATION FOR BORES UP TO 10"  A 10" BORE OR LARGER THE FEE WILL BE $50.00 PER INCH DIAMETER OF PIPE

Company/Person Requesting Road Bore  _____________________________________

Address of Requesting Company/Person 

 ______________________________________________________________________

Phone Number       _________________________________________

Contact Person         _________________________________________

Contact Phone Number _____________________________________

Contact Email Address  ___________________________________________

Contact Fax Number _____________________________________________

Location of Road Bore and Description of Procedure:

              __________________________________________________________

              __________________________________________________________

              __________________________________________________________

              __________________________________________________________

 

 

Trustee Signature  __________________________________  Date  ______________

Trustee Signature  __________________________________  Date  ______________

Trustee Signature  __________________________________  Date  ______________