Fillable File - Eng Construction Permit Application 2017-000 (Town of Superior)

Fill Online, Printable, Fillable, Blank File - Eng Construction Permit Application 2017-000 (Town of Superior) Form

Use Fill to complete blank online TOWN OF SUPERIOR (AZ) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

File - Eng Construction Permit Application 2017-000 (Town of Superior)

On average this form takes 14 minutes to complete

The File - Eng Construction Permit Application 2017-000 (Town of Superior) form is 2 pages long and contains:

  • 0 signatures
  • 25 check-boxes
  • 44 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Town of Superior

BROWSE TOWN OF SUPERIOR (AZ) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Permit Number 2017-_______
TOWN OF SUPERIOR Submittal Date: ____________
ENGINEERING CONSTRUCTION PERMIT APPLICATION
Town of Superior - 199 Lobb Avenue - Superior, AZ - 85173
Tel: 520-689-5752 Fax: 520-689-5822
SELECT PERMIT TYPE:
UTILITY GRADING & DRAINAGE PAVING LANDSCAPING STREET CUT OTHER
SECTION I: APPLICANT Owner Contractor Engineer
SECTION II: OWNER
Owner’s Name ___________________________________________ Phone No. _____________________
Address __________________________________________ City, State, & Zip _____________________
Owner’s Sig. & Date ______________________________ Print Name ___________________________
SECTION III: CONTRACTOR
Contractor _______________________________________________ Phone No. ____________________
Address __________________________________________ City, State, & Zip _____________________
License No. & Type _______________________________ Job Site Contact & Ph. ________________
Town Business License No. _______________________ State Tax No. _________________________
Insurance Expiration Date ________________________ Bond/Security Deposit _______________
Contractor’s Sig. & Date __________________________ Print Name ___________________________
SECTION IV: PROJECT ENGINEER INFORMATION
Engineering Firm ________________________________________ Phone No. _____________________
Address __________________________________________ Email Address ________________________
Name of Professional Engineer _______________________________ P.E. No. ___________________
Geotechnical Engineer ________________________________________________________________
Address _________________________________________________________________________________
Business Phone __________________________________ Email Address ________________________
SECTION V: PROPERTY INFORMATION
Project Name, Phase & Unit No. __________________________________________________________
General Location ________________________________________________________________________
I have read the Engineering Construction Permit submittal application and packet and understand that if my
application is not complete in all respects, it will be returned without review until such time as it is complete.
Signature Print Name Date
Permit Number 2017-_______
TOWN OF SUPERIOR Submittal Date: ____________
ENGINEERING CONSTRUCTION PERMIT APPLICATION
Town of Superior - 199 Lobb Avenue - Superior, AZ - 85173
Tel: 520-689-5752 Fax: 520-689-5822
SUBMITTAL REQUIREMENTS AND FEES
(Applicant Check)
NOTE: If Improvement Plans require Review & Approval, Go to Step 1 - If Improvement Plans are Approved, Go to Step 2.
STEP 1 (3) Copies of Improvement Plans/Reports not previously approved through the platting process
with right of access documentation.
STEP 2 (3) Copies of the approved & signed Improvement Plans (half sizes will be accepted) for the
following: Total No. of Sheets _________
Field Copy
Office Copy
Applicant Copy
Application for Construction Permit
Copy of Contractor’s Liability Insurances ($2,000,000)
Pinal County Dust Permit
SWPPP
Traffic Control Plans
ADEQ Approval of Construction
Construction Schedule
Engineer’s Construction Cost Estimate
Fee
STEP 3 - FEES
Review Fee (Refers to Step 1 Only)
Review $______ per sheet $ _______________
Report review (hourly with 4 hour minimum@ $100/hour) $ _______________
Miscellaneous Fees for ___________________________________ $ _______________
Inspection Fees
Base Fee $ ________________
Hourly based upon Estimate /Third Party Agreement $ ________________
TOTAL $______________
The Foregoing Application is hereby approved and permit issued by the Town of Superior subject to
full compliance by the applicant with all provision and conditions stated in the Application and as
outlined in the attached Special Provision.
Permit Approved By ________________________________________ Date ______________________
Pre-Construction Meeting Date _______________________ Expiration Date ___________________
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

File - Eng Construction Permit Application 2017-000 (Town of Superior)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document