HomeMy WebLinkAbout5188 Gore Circle.pdf 1
MUST BE SUBMITTED MIN 3 BUSINESS DAYS PRIOR TO PERMIT ISSUANCE
APPLICATION FOR
RIGHT OF WAY USE-STREET CUT PERMIT
PR,!#: Town of Vail
PW#: Public Works Dept
Parcel#: 1309 Elkhorn Dr
Bldg Permit#: B - Vail,CO 81657
WARNING: Inclusion of false information in this permit application establishes 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:$100.00
Company
Company Name: 1 D4 Gf d rz Jls G Phone: 6770 .3 q o 974/0
City/State/
Company Address: Zip: 1/n l L (7 110/ . _. -`
Contractor
License Number: Email: - L .t,O'/me- Se4 c-iire,t.
•--� Contact
Contact Name: .)f r v� jttdli/73 6'7' F Phone: (3 ) 0 Ti 470 g 'Q
ROW Use Location: `S 6 Qr_ C1 rd.e ) .
Requested ROW ;,. Requested
Use Dates: ....u. /.2A-. � c Work limes:
Purpose for Request: f Street Cut.Dimension (if applicable):
❑ Underground Utility Installation
❑ Landscaping Length:It
❑ Temp Site Access
11 7 4
❑ Construction Staging Width (min 4'):
❑ Roadway Construction1 i66.
iii � g .
' Other(explain): Pi4€rG Total Square Footage:
Requested ROW Use: '� N\ \ r
„Fr i
❑ Single Lane Closure–Ift of closure(including taper)
❑ Two Lane Closure–Ift of closure(including tape) • –A —._
❑ Three Lane Closure–Ift of closure (including taper .F . - –
❑ Sidewalk/Bike Path–Ift of closure
❑ Other(explain}._ .. - t
1. Applicant shall ubmit .a traffic control plan,and work site/stagingplan with this application Traffic Control
Plan shall be in compliance with,the MUTCD and shall show streets w€th names,adjacent Intersections,
advanced wa_rnir`g signage,.taper lengths, buffer space and work one dimensions. No full street closures
are allowed: , t
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.
Xcel 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 it Electric(970-479-21 8) Town of Vail Irrigation(970-479-2158)
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int A•• .. Applicant Signature ate
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Permit Fee Worksheet
ROW Use(min$50)
Construction Season(as defined by Town of Vail Municipal Code)
FeeDa Lft of Closure
Single Lane $ 0.15 x x = $ -
Two Lane $ 0.45 x x = $ -
Three Lane $ 1.50 x x = $ -
SidewalklBike Path $ 0.15 x x = $ -
Fee Months Sqft of Closure
Paved Surface $ 0.25 x 1 x 400 = . $ 100.00
Non-Paved Surface $ 0.05 x 1 x 400 = $ 20.00
Fee Weeks Sqft of Closure
Core Areas Heated Streetscape $ 0.25 x x = $ -
Non-Construction Season(as defined by Town of Vail Municipal Code)
FeeDa Lft of Closure
Single Lane $ 1.00 x x = $ -
Two Lane $ 3.00 x x = $ •
Three Lane $ 6.00 x x = $ -
Sidewalk/Bike Path $ 0.50 x x = i $ -
Fee Months Sqft of Closure
Paved Surface $ 1.00 x x = $ -
Non-Paved Surface $ 0.20 x x = $ -
Fee Da Sqft of Closure
Core Areas Heated Streetscape $ 0.50 x I x = $ -
Sub-total $ 120.00
Street Cut(min$50)
Non-Moratorium Streets
Surface Fee Sqft of Cut
ACC/PCC $ 0.30 x = $ -
Brick Paver $ 1.00 x $ -
Pothole(each) $ 50.00 x = $ -
Non-Paved Surface $ 0.05 - $ -
Moratorium Streets
Surface Fee Sqft of Cut
ACCIPCC $ 5.40 x = $ -
Brick Paver $ 15.00 x = $ -
Pothole(each) $ 200.00 x = $ -
Non-Paved Surface $ 0.25 = $ -
Sub-Total $
Applicationllnspection Fee $ 100.00
Total Permit Fee $ 220.00
F IPIMSpecificalionsiRDWY SlandardstPermit Fee Worksheetzls