Street Cut Permit Application

"*" indicates required fields

Project Location*

Blasting*

Yes

Owner*

Owner Phone Number*

Owner Address*

Street Address City State ZIP Code

Contractor*

Contractor Phone Number*

Contractor Address*

Street Address City State ZIP Code

Type of Utility*

Type of Work*

Type of Materials*

Approximate Size of Street Cut*

Scheduled Start Date*

Scheduled Completion Date*

Traffic control shall comply with the requirements of Penn DOT Publication 203 and the Borough Police.

Road/Street Restoration and Paving shall be in accordance with the requirements of the Borough:

1. Base Course - four (4) inches of Bituminous Concrete Base Course
2. Wearing Course - one and one half (1-1/2) inches ID-2 Wearing Course

Utility Plan (mark approximate location - see example below):

Example Image

Upload Utility Plan*

Drop files here or

Max. file size: 20 MB.

Applicant's Name*

Applicant's Phone Number*

Applicant's Email*

Applicant's Address*

Street Address City State ZIP Code

Applicant's Signature*

Date*

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Phone

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Street Cut Permit Application

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