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Street Obstruction Permit


  1. 1. Facility Owner & Contractor Information
  2. 2. Public Works Director's Approval
  3. 3. Signature Page
  4. 4. Office Use Only
  • Facility Owner & Contractor Information

    1. Applicants
      Facility owner and contractor are both applicants with the responsibility to assure that facilities are located and installed in accordance with the attached plans including Village condition and plan modifications.
    2. The applicant herein shall assume all responsibility for any claim of damage or injury against the Village caused by such excavation, the requirements of Section 66.045, Wisconsin Statues and the construction requirements attached hereto. In accordance with Section 66.405 of Wisconsin State Statute, all excavations made contrary to this section will be subject to fines or imprisonment and/or are otherwise not authorized.

      The applicant hereby agrees that he/she will sign and barricade the work site according to the latest Wisconsin Department of Transportation Manual of Uniform Traffic Control Devices and is liable for all damages for failure to erect and maintain suitable barricades, signs and lights.

      The applicant is liable for all costs of permanent repairs and will be billed for these costs up to 5 years following construction for failure to restore or failure of restoration work performed.