CITY
OF
BEAUMONT
APPLICATION
FOR
STREET
CUT
PERMIT
AND/OR
BARRICADING
PERMIT
All information
must
be provided.
Type
of
Work to be
performed:--------------------------------------
Will this work involve excavating or cutting on City
Right-of-Way?-------------------------
YourName:
____________________________________________
_
Business Name:
________________
_
Business Phone:
________________
_
BusinessAddress:
__________________________________________
_
Person overseeing work
performed:-------------------------------------
Phone: Day:
____________
_
Night:
Date(s) Requested:
______________
_
Calendar Days:
Time(s)
of
Day
Requested:-------------------------------------
Applicant shall indemnify and forever hold the City harmless against each and every claim, demand or cause
of
action that may be
made or come against it
by
reason
of
or in any way arising out
of
the closing, blocking, excavating, cutting, tunneling, or other work
by the applicant under permit from the City,
if
such permit is granted.
Signature
of
Applicant:
________________
_
Date:
_______
_
PERMIT
MUST
BE
KEPT
AT
JOB
SITE.
FOR
OFFICE
USE ONLY:
Approved:
__________________
_
Inspected By:
________________
_
Date Approved:
________________
_ Date Completed:
_______________
_
Comments:
____________________________________________
_
White to Office; Yellow to Inspector; Pink to Applicant
* Barricading shall confonn with the Texas Manual on Uniform Traffic Control _Devices, for streets
and
highv•ays. Contractor shall be
responsible for cleaning the construction area. Contractor shall submit insurance.
* Prior to restoring the street according to the attached detail, the Contractor shall contact the City inspector at
311
and request a Civil
Inspection. Failure to do so
\Vill
result in the Contractor coring the repair at his or her expense.
