Job Foreman
Contractor Name
Cell Phone
Scope of Work:
Traffic Restriction:
Construction Date/Time:
Start End (See Note 3)
Construction Hours:
8:30 AM to 4:00 PM Weekend (specify)
24-Hour Other (specify)
Nighttime - 9 PM to 5 AM
Barricade Company:
Note: Separate approval of Traffic Control Plan (TCP) is required. Is TCP Approved? Yes No
1 Traffic Control Plans must be submitted no later than 24 hours prior to the requested start time.
2 Traffic Control Plans submitted on Fridays, weekends or holidays, will have the 24-hour time period begin on the next business day.
5 The Applicant is responsible to maintain the work zone and jobsite in a safe manner.
8 For questions, plan revisions, or date revisions, please contact the appropriate Traffic Engineering Inspector -
Applicant/Job Foreman Approval by Traffic Engineering
Permit No. Date of Approval
Any work outside of the time frame requested is not permitted, and is subject to sanctions prescribed in the Traffic Barricade Design -
Technical Design Manual #7. To revise dates of construction or for new applications, see Note 7 below.
Please complete this form if you are planning on closing or restricting any City streets. This form MUST accompany
the traffic plan provided by your professional traffic company.
Officer Required.
A Police Officer is required when traffic lanes are restricted within 300' of a signalized
intersection. More than one officer may be required due to the type of work being done or the number of signalized
intersections affected by lane restrictions. Officers must be scheduled thru the Police Department 24 hours in
advance at 480-782-4204.
Important Information (please read carefully)
Requests for arterial road closures must be submitted no less than ten days in advance, and will not be considered without prior
communication with the City’s Traffic Engineering representative.
CIP jobs: Steve Lindl - cell 602-377-0010, office 480-782-3453, fax 480-782-3472
Development jobs: Abe Murua - cell 480-212-6204, office 480-782-3477, fax 480-782-3444
If traffic is being shifted between lanes at a signalized intersection, the applicant is required to notify the City 24-hours in advance and
precisely at the time of the switchover. Please contact the Traffic Management Center (TMC) at 480-782-3471.
The Applicant shall ensure that all traffic control devices no longer needed for work in progress, or for safety reasons, are removed from the
roadway. If a barricading company is not available, the Applicant shall remove the barricading prior to leaving the job site.
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