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2. 
4. Application for Trench Permit

   Use this form to apply for a permit for trench work within the City.

6. Fees:

   Application Fee - $50

8. Contractor Information:

   Contractor who will perform the proposed work

10. Contractor Name*
11. Contractor Address*
13. Contractor Phone #*
14. Contractor Contact Person*
15. Contractor Emergency Telephone #*
17. Email Address*
19. Request Information:
21. Location of Trench*

    Enter street address or intersection. 

23. Description of Proposed Trench and Reason*
25. Date of Proposed Work*
    Date of Proposed Work
26. Planned Length of Time at Trench Location
28. Additional Information

    Please provide this information if available at time of permit application

30. Certificate of Insurance #
31. Dig Safe #
33. Operator Name
34. Operator License #
35. Type of Equipment
37. Sketch Upload*

    Note: A sketch or drawing of area affected by requested trench work must be uploaded. 

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field