Right-of-Way and Utility Excavation PermiT

You may opt to complete the Right-of-Way and Utility Excavation Permit Application online or download, complete and return the Right-of-Way and Utility Excavation Permit Application (PDF) form.

PDF Form Instructions: Please return completed form and required documents to: Guy Gever, Director of Public Works via email to Guy Gevers or via mail to 200 West Booneslick Rd., Warrenton MO 63383. A Drop Box is available in the City Hall lobby during business hours.

"*" indicates required fields

Project Description*

Applicant Information

Applicant Name*

Applicant Email*

Applicant Address*

Street Address City State ZIP Code

Contact Person*

First Last

Office Phone*

Cell Phone

Subcontractor Information

Name of Subcontractor performing work

Subcontractor Address*

Street Address City State ZIP Code

Subcontractor Contact Person*

First Last

Subcontractor Office Phone*

Subcontractor Cell Phone

Project Information

Applicant is responsible for all locations and Missouri State One Calls (including registration of new utility). Please describe and check all that apply. The Permit application will not be processed until this is received. Attach two scale drawings of project area. The drawings will show all existing and proposed right-of-way, curb, sidewalk, trails, above and below ground facilities or appurtenances, and poles.

Scale Drawings*

Attach two scale drawings of project area. The drawings will show all existing and proposed right-of-way, curb, sidewalk, trails, above and below ground facilities or appurtenances, and poles.

Drop files here or

Max. file size: 50 MB, Max. files: 2.

Nature of Work (Check all that apply)*

Type of Surface to be disturbed (Check all that apply)*

Concrete Street

Gravel

Sidewalk

Easement

Asphalt Street

Alleyway

Other (signs, trees, etc.)

Please list other surface type(s) to be disturbed*

Location Subdivision*

Location Address*

Materials Used: Size and type of pipe, conduit, or cable*

Voltage or Pressure*

Length*

Depth from surface*

Distance from curb or center line*

Clearance on pole*

Method of Installation (Check all that apply)*

Trench

Plow

Directional Bore

Backhoe

Pneumatic Gopher

Hand Dig

Other

Please list other installation method(s) to be used*

Estimated Start Date*

Estimated End Date*

Will detouring of traffic be necessary? (Traffic control must comply with MoDOT Standards)*

Yes

No

Restoration Planned (All restoration must be in-kind)*

Bituminous Paving

Motorized Tamper (Compaction)

Machine Formed Curb

Hand Formed Curb or Sidewalk With Forms

Sodding with 6” Topsoil

Seedling with 6” Topsoil

Excavation Permits are issued subject to all the terms, conditions, and requirements of Chapter 520 of the Warrenton City Code. By executing this application and accepting the Excavation Permit, Applicant agrees to fully comply with all terms, conditions, and requirements of Chapter 520 of the Warrenton City Code of Ordinances.

Applicant Signature*

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Right-of-Way and Utility Excavation PermiT

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