Public Works Department
Engineering Division
Right Of Way Office
Office 712-890-5296
Location of Activities Address:
City of Council Bluffs, Iowa
Street, City, State, Zip
Property Owner Name:
Property Owner’s Address if different than location of activities address
Applicant Name:
Company Name:
Applicant Address:
Street, City, State, Zip
Phone #: ( ) -
Cell Phone #: ( ) - Fax Phone #: ( ) -
Applicant E-mail address:
Applicant: (Select one) Property Owner Contractor Sub-Contractor Business
Application Date: /_ /
Proposed Start Date: / _/
Completion Date: / /
Description of Activity:
Request to use the Right-of-Way (ROW) for the following purpose:
Dumpster Container Equipment Materials Address Other
Location within the Right-of-Way In the Street Behind back of curb Other
Note: In some cases, a drawing and or a site visit may be required by the City for its review before a permit will be issued.
Applicant Signature:
By signing this application, I hereby agree to abide by the terms of the Standard Permit Conditions and if applicable, any
Supplemental Permit Conditions, if a permit is issued.
Date / /
Signature from the Right-of-Way Division or Engineering
Date /_ /_
Applicant Signature:
Signature to Authorize Charge to Credit Card on file with the City Treasurer for this permit only
click to sign
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Standard Permit Conditions
Construction Work in Public
The applicant agrees that if granted a permit to perform work within the public right-of-way (ROW) as described in the
permit application form, the following stipulations or conditions shall govern.
1. The applicant must file the proper permit application form with the Public Works Building Division at 209 Pearl
Street, Council Bluffs, Iowa, 51503
2. All FEES must be paid upon obtaining a permit (see the attached schedule of fees) prior to commencing
3. All permits must be obtained prior to commencing activities within the Public Right-of-Way (ROW). In the case
of emergency repairs please consult with the Public Works ROW department concerning the issuance of the
proper permits.
4. Individual issued permits will remain on file for 60 days from the approval date of the permit. If the work is not
begun during that time, the permit will become null and void with the exception of large sites where the work is
phased. A new permit will have to be obtained at the time the work is to be done for permits that
5. Any activities undertaken within Public ROW shall comply with all laws, regulations, and ordinances enforced
in the City of Council Bluffs, now or put in place hereafter.
6. All disturbed surfacing shall be replaced to its original condition satisfactory to the Public Works
Grass surfaces may be seeded and mulched or sodded.
7. The applicant shall assume all responsibilities for sediment and erosion control during the activities.
8. Parks Department shall be notified immediately of any damage to tree trunk, limbs, or roots within the drip line
of any City tree.
9. The applicant agrees to provide all traffic control measures required. Said applicant shall furnish, erect and
maintain the necessary traffic control such as barricades, signs and flaggers as required. All traffic control
in accordance with the “Manual on Uniform Traffic Control Devices for Streets and Highways” as adopted by
the Iowa Department of Transportation. All activities shall be performed in adherence with public safety.
10. The applicant shall be responsible for notifying all appropriate agencies such as 911 non-emergency
communications and Public Works Traffic Division of any lane closures or street closures. This notification
shall be a minimum of 48 hours in advance of the closure.
11. The applicant agrees to abide by Supplemental Conditions attached to the permit.
12. Applicant / Contractor shall be responsible for scheduling any required inspections. All inspections require 24
hours advanced notice. The applicant / contractor shall be present during the inspection to answer questions or
provide information as requested by the City inspector.
13. The City reserves the right to terminate or revoke the use of Public ROW at any time. The permitee shall be
responsible for the removal of any feature placed within the ROW within the timeline specified by the notice of
termination or revocation. Failure to do so shall enable the City to remove such items with the permittee
reimbursing the City for any costs incurred.
14. The applicant agrees to the terms set forth herein and specifically agrees to protect, indemnify, defend, and hold
harmless the City and its agents against any and all damages or injuries that may occur during the time that this
permit is active.
15. Failure to adhere to these permit guidelines or to public safety may result in civil citations being issued for each
daily occurrence.