HomeMy WebLinkAbout1709 Geneva Dr. PW Permit.pdf MUST BE SUBMITTED MIN 3 BUSINESS DAYS PRIOR TO PERMIT ISSUANCE
�(A.k orgy,,,,, V1M•i.StL APPLICATION FOR
\ L RIGHT OF WAY USE-STREET CUT PERMIT
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PRJ#: Town of Vail
PW#: 00'�'�.,'�0 Public Works Dept
Parcel #: ` �� a 1309 Elkhorn Dr
Bldg Pennit# 3
: B =0 0 4 ! � Vail,CO 31657
\YARNING: Inclusion of Use information in this permit application establishes an automatic denial for a Right of Way Use-
Street Cut Pennit and forfeiture of application fees. By signing this permit,the applicant declares heishe has read ail contents of
this document,Town of Vail Roadway Standards and chapters of Title 8—Public Ways and Property,ot'the Vail Municipal Code
and is fully aware of its requirements and agrees to pay ull applicable lies. Application Fee! $100.00
✓1 G C`4-RJ‹ Company ( ?
Company Name: � ��� Phone: 1 r 0 3 7 Lk2
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City/State/ C� ?AUS
Company Address: 0 - Zs� Zip:
Contractor — `iC7 rnCt�SA
License Number: 1 Email: Y '�
Contact 376 -2
Contact Name: ��`�t a Phone: ��
ROW Use Location: l 0 Q-A CLVfi�
Requested ROW s4 \/ I Requested Q
Use Dates: _ -- lo f I�/ Work Times:
Purppse for Request: Street Cut Dimension(if applicable):
Br Underground Utility Installation \` z
❑ Landscaping Length:
❑ Temp Site Access f f
❑ Construction Staging Width(min 4'): (j
❑ Roadway Construction
❑ Other(explain): ,Se__ 42.f-
Other Total Square Footage:
Requ ed ROW Use: I
Single Lane Closure-• Ift of closure(including taper)
❑ Two Lane Closure - Ift of closure(including taper)
❑ Three Lane Closure., Ift of closure(including taper)
❑ Sidewalk/Bike Path- lit of closure
❑ Other(explain):
1. Applicant shall submit a traffic control plan,and work site/staging plan with this application. Traffic
Control Plan shall he in compliance with the MUTCD and shall show streets with names,adjacent
intersections,advanced warning signage, taper lengths,buffer space and work zone dimensions. No full
street 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.
\cel Enery (800-922-1987) Qwest(800-922-1987)
Comcast(8i)0-922-1987) Holy Cross Electric(800-922-1987)
Eagle River Water K Sanitation District(970-477-5453)
Town of Vail Electric(970-479-2158) Town of Vail Irrigation(970479-2158)
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Print Applicant Name Applicant Signatu O��4
F.PW Engincering PW Pennit lamas Public Way Pennit ROW Application 200R doe