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(Office Use only)
Public Works Road Division P.O. Box 5010, 3745 Owl Creek Road Snowmass Village, CO 81615 Phone: 970-923-5110 Fax: 970-923-3794
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
(Allow 7 business days for permit approval)
Street address
Please provide the length x width in square feet for the appropriate improvement.
____ Long x _____wide (SF)
____Long x ____wide (SF)
____Long x ______wide (SF)
length of culvert
(Office Use Only. Permittee will be issued any special instructions below if necessary.)
(For office use only. Public Works to determine fees.)
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.
Contractor
Date
Permit Approval By
(For office use only)
This field is not part of the form submission.
* indicates a required field