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Road Occupancy Application/Permit

  1. FRANKL~4


  2. ROAD OCCUPANCY APPLICATION/PERMIT

  3. SECTION 1 - APPLICANT INFORMATION

  4. SECTION 2 - PROJECT INFORMATION  (Complete all that apply)

  5. Work Location:  (provide address or from-to description)

  6. Work Schedule: 

  7. Check all that apply*
  8. For Borough Use Only

  9. SECTION 3 - FEES

  10. Permit Fees

  11. $_________________  Driveway Opening:  Residential - $30.00 
                                                                            (if no building permit is issued)                            
                                                                        Commercial - $50.00
    $_________________ Street Opening:  Pavement Opening - $70.00 - Plus $2.00 per LF
                                                                              (LF = Linear Foot)
                                                                      Shoulder Opening - $50.00
                                                                      Outside of Shoulder Opening/Right of Way - $50.00

  12. Inspection Fees

  13. $_________________  Driveway Opening:  Residential - $20.00
                                                                        Commercial - $40.00
    $_________________  Street Opening:  Pavement Opening - $40.00
                                         Shoulder Opening - $25.00
                                         Outside of Shoulder Opening/Right of Way - $20.00 per hour


  14. $_________________ TOTAL FEES

  15. Date Fees Paid ______________________
  16. Has performance guarantee been provided?*
  17. I acknowledge the aforementioned information and all General Provisions.

  18. Accept this as my electronic signature.*
  19. Permit Approved:  ________________________________________________

  20. Date:  _________________________

  21. Final Inspection: __________________________________________________

  22. Date:  _________________________

  23. Leave This Blank:

  24. This field is not part of the form submission.