2. Town of Avon Public Works
   P.O. Box 975 Avon, CO 81620 970.748.4100 Inspection Request Line: 970.748.4094
4. Date:
   Date:
6. ROW Permit No.:
7. Building Permit No.:
11. Permittee (Property Owner/Utility Company) : *
13. Mailing Address*
15. City*
16. State*
17. Zip*
19. Contracted Constrution Agent*
21. Address2*
23. City*
24. State*
25. Zip*
29. Project Location: Attach a site plan and any other exhibits and any other exhibits including plans, maps, or details as required by Public Works to fully define all work to be performed within the public right-of-way. For excavations paralleling roadways or right of ways, show location with respect to roadway and/or right-of-ways.
31. Lot:
32. Block:
33. Subdivision:
35. Site plan or exhibits to define work:
37. Street Address of Project Location:*
39. Project Description:
    (e.g., site preparation, new construction, utility installation)
41. Independent Testing to be Performed by:
43. Starting Date:
    Starting Date:
44. Completion Date:
    Completion Date:
48. Permittee is responsible for obtaining the proper location and protection of all public utilities. Permittee Guarantees work for two years from final inspection date:
49. Both the Town of Avon departments of Community Development and Public Works MUST BE informed at least 24 hours prior to the start date of all construction in order to provide inspection during construction.
51. If dissatisfied with construction performed on this job, please first contact:

    1. Permittee

    1. Contacted Agent

    1. Other:
55. The undersigned hereby acknowledges that he/she has read the Town of Avon “Standard Conditions for Right of Way Use Permit for ALL Construction Work within Public Ways”, and will perform all work under this permit in accordance with these conditions.
57. Standard Conditions for Right of Way Use
    Standard Conditions for Right of Way Use Permit for ALL Construction Work within Public Ways
59. First Name
60. Last Name
62. Date:
    Date:
66. Useful Phone Numbers:
    Utility Locates (800) 922-1987 or 811 (Utility Notification Center of Colorado, UNCC) Community Development Inspection Requests: (970) 748-4094 Public Works Inspection Requests (970) 748-4100
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70. 1. Receive an email copy of this form.
71. Email address

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