HomeMy WebLinkAbout7-4 Utility Occupancy Permit - StormMail To:
City of Bozeman Engineering
P.O. Box 1230, Bozeman, MT 59771
Or Fax to: 406-582-2263
Permit Number:
PUBLIC RIGHT-OF-WAY UTILITY OCCUPANCY PERMIT
Applicant Information
Applicant/Utility: Phone:
Mailing Address:
Email for Permit Correspondence:
Contractor: Phone:
Project Information
Facility Type: Overhead Trenched Underground
Bored, Pushed, Trenchless Other
Detailed Description of Proposed Installation:
Location (Identify in detail the streets, alleys or public easement where this
installation is proposed:
Proposed dates of work:
Attach construction drawings (3 copies) which are to be incorporated with this permit. Distances
from right-of-way line, centerline, and existing utilities, to the proposed installation MUST BE
PROVIDED. All above-ground structures must be clearly identified on the drawings.
Street Cut Permit: If the proposed installation will require trenching, potholing or any other
disruption of the traveled roadway (street or alley), roadway shoulders, or pedestrian or bikeway
facilities, a Street Cut Permit must be obtained prior to commencing work.
Traffic Impacts: If the proposed installation will require the closing of one or more lanes of traffic, a
detailed Traffic Control Plan must be attached and incorporated with this permit. All construction
zones shall be signed in accordance with the Manual of Uniform Traffic Control Devices (MUTCD).
Permit Conditions: This installation is subject to compliance with the City of Bozeman’s Utility
Occupancy Guidelines and the following requirements:
1. The Applicant/Utility will notify the City Engineer at least 48 hours in advance of
initiation of any work detailed in the permit with the exception of emergency
situations.
2. The City of Bozeman shall not be liable to the general public for any injury to or
death of any person whomsoever belonging when such injury, death, loss or damage
arises out of or results from the construction, maintenance, or repair of existing or
future utility facilities located within public right-of-way, or the installation or
operation of such utility facilities within the public right-of-way, regardless of
whether or not the City of Bozeman has expressed or implied approval of the
construction, maintenance, repair, installation or operation of such facilities within
the public right-of-way. In accepting this permit, the Permittee, its/his/her
successors or assignees, agrees to indemnify the City and hold it harmless from all
claims, actions, liability, and damage of every kind and description which may
accrue to or be suffered by any person or person, corporations or property by
reason of the performance of any such work, character of materials used, or manner
of installations, maintenance and operation, or by the improper occupancy of said
roadway right-of-way, and in case any suit or action is brought against the City and
arising out of, or by reason of, any of the above causes, the Permittee, its/his/her
successors or assignees, will upon notice to it/him/her of the commencement of
such action, defend the same at its/his/her sole cost and expense and satisfy any
judgment which may be rendered against the City in any such suit or action. City
includes its officers, employees, agents and assignees.
3. This approval is granted with the understanding that the installation will be made
according to the plans as submitted. Field revision may only be made with the
approval of the City Engineer or designee. If the installation is not made as shown on
the plans or approved amendment, the City of Bozeman, at its discretion, may require
the removal of the installation.
4. CONSTRUCTION, MAINTENANCE, REMOVAL OF INSTALLATION OR STRUCTURES.
Permittee, at permittee’s sole cost and expense shall construct, maintain, replace,
relocate and/or remove the installation, facility, or structure in accordance with the
applicable City and industry standards. Furthermore, after completion of any of the
aforementioned construction, permittee shall fill in any excavations and restore the
right-of-way to its original condition. The City shall have the right at any time to
require permittee to maintain, reconstruct, replace, relocate and/or remove its
facility from the right-of-way, all at the permittee’s expense.
5. Additional Requirements:
Applicant Signature (required)
Signature: Printed Name:
Utility:
Title: Date:
Official Use Only
Approved _ Disapproved
By:
Title: Date:
Permit Fee: Permit Number: