Construction Street Use Permit

2. 

3. Street Use Permit Application

   Construction Roadway Closure
   

   
   
   

   This permit is necessary when a roadway and part thereof must be closed for construction activities. Common uses include road tie-ins, house moves, and similar construction-related purposes. 

   Applications for Construction Roadway Closure - Street Use Permits must be submitted at least 10 business days prior to the requested day of use.

7. Applicant & Contact Information

9. Business Name*
11. Contact Name*
13. Email Address*
14. Phone Number*
16. Mailing Address
18. City
19. Prov
20. Postal Code
22. Name of primary contact on day of closure:
23. Primary #
24. Alternate #
26. Name of secondary contact on day of closure:
27. Primary #
28. Alternate #

32. Project Information

34. Name of Project*
36. Development Permit Number*
37. Building Permit Number*
39. Street Address*
40. Subdivision*
42. Nearest Intersecting Street*
43. Attach site map
45. Type of Work*
47. Purpose of Construction*
49. Project Start Date*
    Project Start Date
50. Project Completion Date*
    Project Completion Date

54. Closure Details

56. Nature and Objectives of Closure*
58. Dates & Times of Closure*
    Dates & Times of Closure Start Date

    Dates & Times of Closure Start Time

    —

    Dates & Times of Closure End Date

    Dates & Times of Closure End Time

    Start Time (including setup) - End Time (including takedown)

60. Highway(s) / Road(s) Required *
62. Between (street)*
63. and (street)*
65. Between (street)
66. and (street)
68. Will any escort vehicles / patrol vehicles will be used? *

    1. Yes
    2. No
69. Escort / Patrol Vehicles*

    Provide details on how these vehicles work along the highway(s)

71. Is traffic control required? *

    1. Yes
    2. No
72. Traffic Accommodation Strategy*

    If so, a complete Traffic Accommodation Strategy (TAS) with signage diagram(s) is required. 
    Attach to this application. 

74. Who will be responsible for the implementation of the Traffic Accommodation Strategy?*
76. Briefly describe how the work will affect traffic (pedestrians, cyclists, vehicles, etc.)*

78. The contractor/Applicant is to notify Civic Operations and receive permission in writing prior to excavating.

80. Supporting Documentation

    
    

    PROVIDE A COPY OF THE FOLLOWING:

82. Certificate of Insurance*

    Certificate of Insurance with a minimum of $2 million liability with a waiver against third-party claims. A maximum deductible shall not be greater than $3,000.00. Name Town of Diamond Valley as an additional insured party.

84. Required Approvals

    Provide a list and copy of the approval from other authorities who may have an interest in the event. Such as Alberta Transportation and Diamond Valley Fire Rescue.

86. Map & Diagrams

    As applicable, if not attached above.

90. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
92. Electronic Signature*
Leave This Blank:


94. 1. Receive an email copy of this form.
95. Email address

    This field is not part of the form submission.

96. Submit

* indicates a required field