HomeMy WebLinkAbout183 Gore Creek Dr._4.pdf MUST BE SUBMITTED MIN 3 BUSINESS DAYS PRIOR TO PERMIT ISSUANCE
APPLICATION FOR
RIGHT OF WAY USE-STREET CUT PERMIT
PRO: 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 fora 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 Roads ay 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
ULA' '� Company °I?O- 4 2� -7(. v U
Company Name: �.'� Phone:
City/State/
Company Address: 275 M e.i n Sk C 1a S Zip: teLWcrch / Ci 516,3 Z
Contractor
License Number: Email: J t.ThA 'Q malt-1.114I
Contact
Contact Name: 1-5- LOA 111 ra 19 Phone: CM) - Gag• 17 t
ROW Use Location: I $3 Gore Creek 'b-
Requested ROW Requested
Use Dates: 1/1/4 to Work Times: 7: 3O Ate- 10'.30 Aft
Purpose for Request: Street Cut Dimension (if applicable):
C Underground Utility Installation
C Landscaping Length:
C Temp Site Access
C Construction Staging Width(min 4'):
C Roadway Construction
Other(explain): Crone to Smock/.se.t rileifilek Total Square Footage:
Requested ROW Use:
Single Lane Closure—Ift of closure(including taper)
C Two Lane Closure—Ift of closure(including taper)
C Three Lane Closure— Ift of closure(including taper)_
ti Sidewalk/Bike Path—Ift 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 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.
Xcel Liter), (800-922-1987) Qwest(800-922-1987)
Comcast(800-922-I987) 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)
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Print Applicant Name pp cant Signature Date
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