Mail: Engineering 4
th
Floor, P. O. Box 27210 Tucson, Arizona 85726-7210 / Email: tdotpermitcenter@tucsonaz.gov
Revision date: 112018
Contractors and or Sub-contractors:
Company Name: Contact Name: Cell #
Yes Send Permit Email: ROC #
Company Name: Contact Name: Cell #
Yes Send Permit Email: ROC #
Barricade Company: Contact: Cell #
Yes Send Permit Email: Office Number:
Traffic Control Setup Duration: (Please check the appropriate boxes if applicable) Not applicable _________ Initials required
Some Exceptions with Minimal Impacts to Traffic Flow: (for off-peak travel direction)
Day 6AM-3:30PM Lane Direction: North South East West
Day 9AM-6:00PM Lane Direction: North South East West
Other hours Lane Direction: North South East West
Indicate any Restrictions: (Please check the appropriate boxes if applicable) Not applicable _________ Initials required
Bus Route/Stop Interruptions (Notify Sun Tran 623-4301) Bike Lane Interruptions (“Share Road with Care Sign” or Detour required)
Left Turn Lane Restrictions - Location/Duration:
Parking Meters or Freight Loading Zones Meter or Zone numbers
(MUST Notify Park Tucson 791-5071) (Info is found on the pole below each meter or bottom right corner of sign)
Indicate any Notifications: (Please check the appropriate boxes if applicable) Not applicable _________ Initials required
Citizen Notification for Major Impacts Residents/Businesses Notified
School Notified – School Name:
TDOT Permit Center will only accept fully completed applications. If application is rejected, applicant will need to resubmit a new
completed application.
A Traffic Control Plan must be submitted along with the application for complete street closure and for any major impacts that occur
on Arterial and Collector Roadways, including one day operations.
A Site Plan no larger than 11” x 17” must be submitted along with application for all excavation, bore, and manhole work.
Contact Arizona 811 before you dig.
The applicant certifies that the Traffic Control Devices and Plan are in conformance to Part VI of the Manual on Traffic Control
Devices (MUTCD) as amended by the State of Arizona, Tucson’s City Code 25, and any other standards set forth by the City
Transportation Director.
If your project extends beyond the permit’s expiration date, you must renew it 24 hours before it expires. If you do not renew within
24 hours, another application will be required and a new permit number will be issued.
If you close a road or alley, you must provide written notice three working days in advance to the following parties: Affected school
districts, emergency services, businesses, residences, Ward offices, Environmental Services, postal service and the news media.
Show all Tucson Water (TW) facilities within the project limits on the project plans (label water main size, material, and as-built plan number). TW
maps and record drawings are available at TW Mapping Section 520-791-2658. If work is within 10-feet horizontally or crossing an existing 16” or
larger diameter water main, plans must be submitted to TW Distribution Design for review and comment. Plan review may take up to 15 business
days to complete and large projects may require longer review time. Initial here _____ to acknowledge compliance.
For work impacting a drainage way, a Floodplain permit may be required. Contact TDOT Floodplain 791-5100. Initial here _____ to
confirm you have contacted TDOT.
To determine the location of Storm Drains check the TDOT As-Builts at 201 N. Stone Ave., 4
th
Floor, Maps & Records 791-5100.
Initial here _____ to confirm you have contacted TDOT.
A Track Access Permit will be required prior to issuance of a right-of-way permit. Contact Sun Link at 791-3333. Initial here _____ to
confirm you have contacted SunLink.
Work within an ADOT Right-of-Way will require the ADOT’s Encroachment Application to be completed and included and may
require an ADOT review prior to permit issuance. Initial here _____ to acknowledge compliance.
In the Downtown Area and on Arterial/Collector Streets, the appropriate agency for the work will be required to have in place at least three
days prior to the start of a work electronic message boards indicating the upcoming travel restrictions. The message boards shall be placed in
locations ahead of the travel restrictions for all directions of travel. Must notify City Communication 791-4434. Initial here _____ to acknowledge.
Applicant shall be responsible for obtaining utility clearances for existing utilities located within the project construction limits prior
to construction.
Residential neighborhood night work requires approval for Temporary Exemption to Noise Permit per Tucson Code Section 16-31(d).
