APPLICATION FOR RIGHT-OF-WAY PERMIT

(UTILITY PROVIDER – CONSTRUCTION OR MINOR MAINTENANCE)

(Ord. 951.106 et seq.)

Permit No.
Application Date:
    /    /
Permit Expires:
    /    /
APPLICANT INFORMATION
Applicant Name (printed):
Signature:
Company Name:
Phone:
Company Street Address:
City/State/Zip:
If Applicant is a contractor, Utility Provider for whom work will be performed:
PROJECT INFORMATION
Project location: Paved ROW Unpaved ROW
Permit type: Construction Minor Maintenance
Street Address/Location of Project/Parcel No.:
Estimated start date:
    /    /
Estimated completion date:
    /    /
Description of work:

Required attachments (SEE INSTRUCTIONS):

FOR CONSTRUCTION PERMITS:
  • Permit fee made payable to the City of Oakwood (to be submitted upon permit approval and prior to performing any work);
  • Written authority to apply for permit on behalf of a registered Utility Provider (contractors only);
  • Scale drawing of proposed work, number and location of pavement cuts, location of all existing and proposed Facilities, and certification that the proposed project complies with applicable codes, rules, and regulations;
  • Traffic control plan;
  • Facility-specific information (existing and proposed, including excess capacity documentation);
  • Preliminary construction schedule and completion date;
  • Payment of any prior unpaid amounts due to the city;
  • Construction Bond and Removal Bond, if applicable; and
  • Certificate(s) of comprehensive liability insurance, automobile liability insurance, and umbrella insurance coverage (contractors only)
FOR MINOR MAINTENANCE PERMITS:
  • There is NO permit fee;
  • Written authority to apply for permit on behalf of a registered Utility Provider (contractors only); and
  • Traffic control statement.
FOR OFFICIAL USE ONLY
Complete application Fee paid ($ ) Certificate of Insurance Bond (Amount $ ) Inspection card
Permit Approved by:
Date:
    /    /
Comments/Conditions: