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4. Date submitted:*
   Date submitted:
6. Requirements to Obtain a Right-of-Way Permit

   In order to obtain a right-of-way permit, the permit application must be completed along with a sketch of the work location or engineering plans, a traffic control plan if the work includes lane reductions or closures, a $5,000 surety bond which includes a 2-year maintenance period, a $85 application fee, and commercial general liability insurance of $1,000,000 per occurrence and $2,000,000 per aggregate.  (NOTE: For larger, more significant projects, a higher bond amount may be required. Please consult with city staff about these bond requirements.)

   All contractors working in Roeland Park must have a current Johnson County Contractors License and a Roeland Park Occupational License. You can fill out the Roeland Park Occupational License online.

8. Please indicate if you are:*

   1. Utility

   1. Contractor

   1. Property Owner

   1. Other
10. Company/Contractor *
11. Contact Person:*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Email Address*
24. Address and general location of construction or excavation (please include a site plan or map):*
26. Description of work:*
28. Type of work:*

    1. Gas
    2. Water

    1. Electric
    2. Cable

    1. Communications
    2. Driveway with curb cut

    1. Driveway without curb cut
    2. Other
30. Purpose of project:*

    1. New Service
    2. Repair
    3. New Main

    1. Abandon
    2. New Driveway or Sidewalk
    3. Other
32. Method of excavation:*

    1. Open cut
    2. Tunneling or boring
33. Area to be excavated:*

    1. Pavement
    2. Grass
    3. Sidewalk
35. Project start date:*
    Project start date:
36. Project completion date (please give your best estimate of the project's completion date):*
    Project completion date (please give your best estimate of the project's completion date):
37. ROW permits expire six months from the date of approval.
39. Please upload any documents, plans, traffic plans, etc. applicable to this project.
41. File upload:
42. File upload:
43. File upload:
44. File upload:
46. Insurance and Liability Requirements

    A $5,000 surety bond, which includes a 2 year maintenance period, and commercial general liability insurance of $1,000,000 per occurrence and $2,000,000 per aggregate. 

48. Restoration Requirements

    All excavations shall be backfilled within five working days from the date of the original excavation or as directed by the Public Works Director or designee.

    In previously grassy areas, sod shall be laid and watered, as necessary, for a period of 21 days after installation.

    All established areas that are disturbed shall be restored to their original condition. 

50. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
52. Electronic Signature*
53. Date:*
    Date:
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field