HomeMy WebLinkAbout332 Mill Creek Circle Sewer.pdf MUST BE SUBMITTED MIN 3 BUSINESS DAYS PRIOR TO PERMIT ISSUANCE
APPLICATION FOR
RIGHT OF WAY USE-STREET CUT PERMIT
PRT#: Town of Vail
PW#: ,+
Parcel#:4I or 0,9-2f �� g Public Works Dept
1309
Bldg Permit#: B 1' - CO 81657Elkhorn Dr
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 fres. 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
f Company
Company Name:?!}�s 4A /4c r d `'&fps Phone: 970 -107
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Q1 ity/State/� 1 t�C3
Company Address: � � 3 �� Zip: tL CX;�>'� � 5�
Contractor
License Number: Email: at j ' /6fiv� c a co
Contact J
Contact Name: '/� [Q��y` Phone: /7° 3i --/t"7
ROW Use Location: 33A /17//
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Requested ROW /� /� Requested �J
Use Dates: �u W 6 to /-#�4jar, /l Work Times: / ' T�
017,
Purpose for Request: 070/41 Street Cut Dimension(i f applicable):
pc Underground Utility Installation L g
C Landscaping Length: i—
C Temp Site Access
C Construction Staging Width(min 4'): 1/
C Roadway Construction
C Other(explain): Total Square Footage: 7
Requested ROW Use:
Single Lane Closure–1ft of closure(including taper)
C Two Lane Closure–111:of closure(including taper)
C Three Lane Closure–lit of closure(including taper)
C Sidewalk/Bike Path–1ft of closure
C Other(explain):
I. Applicant shall submit a traffic control plan,and work site/staging plan with this application. Traffic
Control Plan shall be in compliance with the M.UTCD 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.
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 Vail Electric(970-479-2158) Town of Vail Irrigation(970-479-2158)
0/arkt' Sul/ dt14 fit; 620
Print Applicant Name / Applicant Signaturep4
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