HomeMy WebLinkAboutRight-of-Way Permit Drive Cut'W + urd � Tom ka55*
MUST BE SUBMITTED MIN 3 BUSINESS DAYS PRIOR TO PERMIT ISSUANCE
APPLICATION FOR
RIGHT OF WAY USE - STREET CUT PERMIT
Town of Vail
PRJ #: / Public Works Dept
PW #: 1309 Elkhorn Dr
Parcel #: / Vail, CO 81657
Bldg Permit #: B -
lication establish
WARNING: Inclusion of false information in this permit app es an automatic denial for a Right of Way Use -
Street Cut Permit and forfeiture of application fees. By signing this permit, the applicant declares he /she has read all contents of
this document, Town of Vail Roadway Standards and chapters of Title 8 — Public Ways and Property, of the Vail Municipal Code
and is fully aware of its requirements and agrees to pay all applicable fees. Application Fee: $50.00 �j,,p
Company
Company Name:
YTD C NW37911070A Phone: gol — J�� — /y /Q
City /State/
Company Address: IIOL5• SOPY )91<w)( Zip:
Contractor . �G' LlecNSE =
License Number: GO/Y Email:_ A�7n'--r �1s • ��
Contact
Contact Name: �%KC'r GAS Phone:
ROW Use Location:
Lij
Requested ROW Use: TEMP lfit* s � VV. NVI�`
❑ Single Lane Closure — lft of closure (including taper)
❑ Two Lane Closure — lft of closure; includin to er.
❑ Three Lane Closure — lft of closure.(includhigtaper)
❑ Sidewalk/Bike Path — lft of closure
0, Other (explain):.
1. Applicant�shall submit;.traffic control plan, and work site /staging plan with this,-application. Traffic
Control Plan shalt be in. compliance with :the.,MUTCD and shall show;streets with names, adjacent
intersections, advanced warning s gnage, taper lengths, buffer'sp`ace and woric zone dimensions. No full
atreet,closures are :allowed.
2. Applicant must contact Public Works Department at 479 -2198 24 hours prior to commencing of work
Failure to notify the Town will result in forfeiture of bond money.
3. Applicant is responsible for obtaining approvals from all utility companies having an existing utility line within
the project site, applicant has option of routing application through the Public Works office to obtain the
necessary Town of Vail signatures. Please allow up to one week to process.
acel Enery (800 - 922 -1987) Qwest (800 - 922 -1987)
Comcast (800 - 922 -1987) Holy Cross Electric (800- 922 - 1987)_
Eagle River Water & Sanitation District (970- 477 -5453)
Town of Vail Electric (970- 479 -2158) Town of Vail Irrigation (970 - 479 -215
Pau CH ' WY
Print Applicant Name Appli. tSignature
F:\PW\Specifications \RDWY Standards \ROW permits \Permit Application.doc
Z6-ao�'
Date
DUPLEX
ENCES
Q 82B
N DRIVE
I
OF STOM
MAY
A
VIC
ig
ho
L. 014
MAINTAIN ACCESS
TO Exis-nNG
FIRE HYDRANT
f.
�:;, IV
J,