City of Charleston
Department of Public Service
Engineering Division
2 George St., Suite 2100, Charleston, SC
29401 Phone 843-724-3782 Fax 843-724-7198
Permit Number
Permit Fee Amount
Cash Check
ENGINEERING PERMIT APPLICATION
Applicant/Permittee
Name:
Company:
Address:
Phone:
Email:
Contractor/Developer
Name/Company:
License:
Address:
Phone:
Email:
24 Hour Emergency Contact Address of Work Site Planned Start Date:
Name: Planned End Date:
Phone:
Permit valid for 30 days from issue date
Type of Work
Obstruction Impacted Infrastructure
ROW Obstruction Sidewalk Blocking Utilities
ROW Excavation Sidewalk Roadway
Roadway Curb
New Easement Stormwater Structure
Service Other: Sidewalk
Repair
Excavation Details
Other:
Emergency Bore Length (ft)
Other: Diameter (in)
Additional Required Documents
Sidewalk Length (ft) (if applicable)
Gas Width (ft) Site Plan showing dimensions
Electric Concrete surface Trafc & Transportation Permit
Telephone Bluestone surface Pedestrian Detour Plan
Cable Sidewalk to be blocked Restoration Plan
Stormwater Other: SCDOT Permit
Irrigation Roadway Driveway apron BAR Approval
Potable Water Length (ft) Zoning Approval
Sanitary Sewer Width (ft) Contractors LLR License #
Trafc & Transportation Concrete surface Call 811 before you dig
Finish: Familiar with applicable standards:
Driveway Asphalt Surface SCDOT Standard Specications for
Roadway Construction
Encroachment Ballast Stone surface
Streets & Sidewalks Brick surface
Utility Pavement Cut & Repair Guidelines
Other: Other: Steel Plate Guidelines
Description of Work (use additional sheets if necessary)
The applicant hereby acknowledges that this permit is contingent upon the permit conditions aforementioned and agrees
to perform all work in accordance with those conditions listed, as well as the City’s specications.
Applicant’s Signature: Date:
Applicant’s Printed Name:
Engineering Division - Updated 8/16/2017
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signature
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