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Town of Snowmass Village Right of Way Work Permit

  1. Permit No:__________________

    (Office Use only)

  2. Town of Snowmass Village Right of Way Work Permit

    Public Works Road Division P.O. Box 5010, 3745 Owl Creek Road Snowmass Village, CO 81615 Phone: 970-923-5110 Fax: 970-923-3794

  3. Instructions for Completion:

    This form is intended to be used as an electronic way to complete the information required for this permit only. Once the information has been entered into this form, additional documentation such as a diagram of work, will need to be submitted either by email or delivered to the Public Works office at 3745 Owl Creek Road. In addition to a diagram of work, a signed copy of this permit along with any fees (if applicable) may also be required once all information is submitted. Please follow up with the Public Works Department at 923-5110 after submittal of this form to ensure that application is complete. CALL BEFORE YOU DIG 1-800-922-1987

  4. Section I: GENERAL INFORMATION:

    (Allow 7 business days for permit approval)

  5. Section II: PROJECT INFORMATION:

  6. Street address

  7. Type of Work?

  8. New or Repair Work?

  9. Purpose of Work?

  10. SURFACE IMPROVEMENTS:

    Please provide the length x width in square feet for the appropriate improvement.

  11. ____ Long x _____wide (SF)

  12. ____Long x ____wide (SF)

  13. ____Long x ______wide (SF)

  14. length of culvert

  15. ATTACH COPIES OF THE FOLLOWING TO THIS DOCUMENT:

  16. Traffic control plan

  17. Landscaping plan

  18. Insurance provided

  19. Diagram/Site Plan of Work

  20. Concrete or backfill and compaction methods for linear runs shall be tested by:

  21. Test results shall be faxed or emailed to this agency within 24 hours, following construction work.

  22. OFFICE USE ONLY:

  23. Special Conditions Requirements:

    (Office Use Only. Permittee will be issued any special instructions below if necessary.)

  24. Fee Structure

    (For office use only. Public Works to determine fees.)

  25. Right of Way Permit Fee:

  26. $300.00

  27. Access Permit Fee:

  28. $100.00

  29. Obstruction Permit Fee:

  30. $100.00

  31. Total Permit Fee:

  32. $_________________

  33. Paid Check #:_____________

  34. Right of Way Security Deposit: $2,000 minimum deposit for 2 years.

  35. Right of Way Security Deposit for shallow utility cuts of 30" or less in depth: $20.00 per sq. ft. of asphalt cut equal or greater than $2,000.00 minimum.

  36. Right of Way Security Deposit for deep utility cuts of 30" or more in depth: $30.00 per sq. ft. of asphalt cut equal or greater than $2,000.00 minimum.

  37. Total *Security Deposit: $______________

  38. *Bonding equal to the cost of the work being completed can be used in place of security deposit.

  39. *Return of Security Deposits is forfeited if not claimed after one year past the two-year warranty period.

  40. Section III: Contractor Signature

  41. In accepting this permit the undersigned, representing the Permittee, verifies that they have read and understands all of the foregoing provisions; that they have authority to sign for and bind the Permittee; and by virtue of their signature the Permittee is bound by and agrees to comply with all Town ordinances, standards and specifications regulating construction.

  42. _________________________________________

    Contractor

  43. ___________

    Date

  44. __________________________________________

    Permit Approval By

  45. ___________

    Date

  46. Inspected By:_____________________

    (For office use only)

  47. Final Inspection By:_____________________

    (For office use only)

  48. Security Deposit Released Date:___________

    (For office use only)

  49. Leave This Blank:

  50. This field is not part of the form submission.