HomeMy WebLinkAboutRightOfWayApplication
H:\kevink\Right-of-Way Permit Application_1-17-24.docx
CITY OF OSHKOSH, WISCONSIN
RIGHT-OF-WAY PERMIT APPLICATION
Permit Type: General Excavation Site-Specific Excavation Obstruction
I. APPLICANT INFORMATION
Company
Contact
Telephone
Email
Date of Application
Address
II. GENERAL CONTRACTOR INFORMATION (if different from above)
Same as above
Contractor to Perform Work
Contact Telephone
III. PROPOSED WORK
A. SCHEDULE Estimated Start Date Estimated Completion Date
B. ADDRESS/LIMITS OF PROPOSED WORK
C. SCOPE OF WORK
D. METHOD OF CONSTRUCTION (check all boxes that apply)
Open Cut Bore Holes Directional (Horizontal) Drilling No Excavation
E. PURPOSE
Install
Repair
Replace
Remove
Dumpster
Traffic control
F. LOCATION
Sidewalk
Travel Lane
Parking Lane
Terrace
Easement/Greenway
Other
G. TYPE OF FACILITY
Gas
Electric
Cable
Telecommunications
Service
Main
N/A
Other
H. STREET
Concrete
Asphalt
PASER 10-7
PASER 10-7
PASER 6-4
PASER 6-4
PASER 3-1
PASER 3-1
IV. CONNECTION TO CITY SANITARY SEWER AND/OR STORM WATER SYSTEM
NEW Sanitary Connection - OR - Existing Sanitary Connection No. of Connections __________
NEW Storm Connection - OR - Existing Storm Connection No. of Connections __________
All connections or repairs for existing or new water services shall be coordinated with the City Water Utility 920-232-5330
All permanent structures to be placed in the public right-of-way, vacated right-of-way or City easement will require a signed
Encroachment Agreement prior to permit approval.
Submit applications to ROWPermits@oshkoshwi.gov or 3rd floor, City Hall, Room 301 – Public Works and Engineering front counter