To perform work within the right-of-way on any roadway under the control of the Davis County Highway Department, the person(s) performing the work must fill out the following form, meet with the County Engineer or his designated representative and agree to abide by all requirements of the permit. This permit may be faxed, mailed, e-mailed or presented in person to set a meeting with the Engineer for the necessary project review. It is necessary that the County be allowed to review sites before a permit may be considered.
Application Number _____________
(Assigned By County)
Permission to Perform Work on
County Right-of Way
Applicant:
_____________________________________________________________
Name of Individual or Company
_____________________________________________________________
Address
_____________________________________________________________
Work will be done in Section(s) ______ Township ______ Range ______ in Davis County, Iowa. More specifically located in:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Work to be Performed:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Agreed upon by:
_______________________ _______________________
County Representative Applicant’s Representative
Date ____________ Date ____________
See Attached Sheet(s) for Additional Details and Descriptions of Work
1. The applicant will at any time subsequent to this agreement, and at his own expense, relay, reconstruct or eliminate the work performed herein as may become necessary to conform to new grades, alignment or widening of the right-of-way, resulting from maintenance or construction operations by the County. The applicant agrees to do this promptly on order by the County, and without cost to the County. If the applicant is unable to comply promptly, the County may cause the work to be done, and the applicant will pay the costs thereof upon receipt of statement.
The County will endeavor to give the applicant sufficient notice of any proposed construction or maintenance work, on either existing or newly acquired right-of-way, that is likely to expose, cover, or disturb work performed by the applicant in order that the applicant may arrange to remove his work described herein. The County assumes no responsibility, however, for failure to give such notice.
2. The County assumes no responsibility for damages to the applicant’s property occasioned by any construction or maintenance operations on said highway, including new or additional right-of-way acquired in connection therewith, subsequent to the placement of construction of work described therein.
3. The County assumes no responsibility for damages to the applicant’s property due to acts of God.
4. The County assumes no responsibility for maintenance and/or repairs to the work described herein that would be in excess of existing County policy and practices.
5. The applicant shall take all reasonable precaution during the construction of said work described herein this permit. They shall protect and safeguard the lives and property of the traveling public and adjacent property owners and shall save the County harmless of any damage or loss that may be sustained by the traveling public or adjacent landowners of such construction operations.
6. Operations in the construction and maintenance of said work described herein shall be carried on in such a way as to not interfere with, or interrupt traffic on said roadway. Strict compliance with the practices described in the current Manual on Uniform Traffic Control Devices shall be adhered to in regards to traffic control.
7. The applicant shall hold the County harmless from any damage that may result to said roadway because of the construction or maintenance of said work described herein, and shall reimburse the County for any expenditure, that the County may have to make on said roadway on account of said applicant’s work described herein having been constructed thereon.
8. The applicant agrees to give the County forty-eight hours notice of it’s intention to start said work herein on the roadway right-of-way.
9. All work performed shall be done in a workmanlike manor, and the ground left in a neat condition satisfactory to the County engineer. All work shall be performed to the satisfaction of the County Engineer.
10. No work is to be performed other than the work described herein.
11. Additional attached requirements as set forth by the County after specific site review.