"*" indicates required fields
This permit shall be null and void if substantial construction has not occurred by September 30th of the current year. If a contractor this to perform the construction work authorized by this permit and is supplying the bond, he will fill out the information block below, and thereby assumes responsibility along with the PERMIT HOLDER for all provisions of this permit. The PERMIT HOLDERS attention is called to the General Conditions attached to this permit.
ALTERATION OR REMOVAL MAY BE REQUIRED BY THE BOARD AT ANY TIME (see General conditions #6) A general description of the facility is as follows: (Indicate size, length, type, use, method of crossing road) for underground construction, give depth to top of facility and distance from centerline of facility to centerline of road. Specify other pertinent detail.
FOUR HOUR INSPECTION COST WILL BE ASSESSED WHEN THE ROAD COMMISSION IS NOT NOTIFIED PRIOR TO ANY CONSTRUCTION
Approved __________________________________________________
Approval Date _____________________________________________
General Permit Fees:
Pier: $100 Pier boat lift (1 per pier) $100
Roads Parade/Run: $100 Road Bore: $100 + $300 inspection dep. Storm or sanitary sewer hookup: $200 + $300 inspection dep. Sewer installation/open cut: $200 + $5000 inspection dep. Sign installation: $100
Utilities Annual maintenance & repair: $50 Annual tree trimming: $250 Seasonal: $50 Right-of-Way: $100 *Broadband New (less than 250,000 pop): $300 *Broadband New (more than 250,000 pop): $600 *Wireless facilities without poles: $200 *Wireless facilities with pole: $300 *Wireless collocate annual existing pole: $20 *Wireless collocate annual new pole: $125 *Wireless collocate road agency pole: $30
*set by State law