Form Center

3. 
5. Pursuant to Section 11-1-2 of the Town Code, all applications must be submitted at least 5 working days prior to the start of construction, and shall be accompanied by at least 3 copies of a drawing, map, blueprint, diagram or similar exhibit sufficient to illustrate clearly the location, dimension, method, traffic control, and purpose of the proposed work. First review of application will be completed in typically 10-15 business days for non-emergency work.
   
   Applicants for the permit may be either an owner or a contractor. However, the work may be performed only by a contractor, utility company, government agency, or property owner under certain circumstances.
   
   Applicants shall deposit an amount in cash or a performance bond equal to 100% of the cost of the work proposed in the application as a guarantee that the work will be completed in accordance with the permit. The performance bond shall be in favor of the Town and shall state that the applicant will faithfully complete the work described in the application in accordance with the plan, specifications and conditions thereof.
   
   A certificate of insurance naming the Town an additional insured shall be submitted at the time of application.
7. Applicant
9. Address
11. Contractor
13. Phone Number
14. Email Address
16. Sales Tax Number
17. Contractor License Number
19. Location of Right-of-Way Work
21. The applicant hereby agrees that all work done in the public streets shall be done in accordance with the permit and with the approved details and specifications of the Town and with all other ordinances, rules and regulations of the Town applicable to such work, including, but not limited to Section 11-1-2 of the Town Code which requires that the right-of-way be restored and repaired in accordance with Town standards and specifications and in such manner that it is returned as nearly as practicable to its original condition and to maintain such restoration and repair for a period of not less than 1 year after its completion.
23. Signature

    1. Signature

    By checking this box, I authorize my signature.
24. Signature Date
    Signature Date
26. No Open Cuts Without Town Approval
30. Row Permit Fees
32. Base Fee
    $50 per permit
33. Quantity
    -- Select One --12345
34. Fee Total
36. Water Line
    $.50 per lineal foot
37. Quantity
    -- Select One --12345
38. Fee Total
40. Sewer Line
    $.50 per lineal foot
41. Quantity
    -- Select One --12345
42. Fee Total
44. Storm Drain
    $1 per lineal foot
45. Quantity
    -- Select One --12345
46. Fee Total
48. Trenching in Paved Right-of-Way
    $.40 per foot
49. Quantity
    -- Select One --12345
50. Fee Total
52. Other Utility Trenching
    $.10 per foot
53. Quantity
    -- Select One --12345
54. Fee Total
56. Boring
    $2 per lineal foot
57. Quantity
    -- Select One --12345
58. Fee Total
60. Paving
    $.30 per square yard
61. Quantity
    -- Select One --12345
62. Fee Total
64. Curb & Cutter
    $.20 per lineal foot
65. Quantity
    -- Select One --12345
66. Fee Total
68. Sidewalk Ramps
    $.10 per square foot
69. Quantity
    -- Select One --12345
70. Fee Total
72. Driveway (New - Cut Into Existing Curb)
    $200 each
73. Quantity
    -- Select One --12345
74. Fee Total
76. Catch Basin
    $40 each
77. Quantity
    -- Select One --12345
78. Fee Total
80. Manhole
    $40 each
81. Quantity
    -- Select One --12345
82. Fee Total
84. Total Permit Fee
88. Plan Review Fees
90. First & Second Review (Required for Nonfranchise Agreements)
    $150 each permit
91. Quantity
    -- Select One --12345
92. Fee Total
94. Third & Each Subsequent Review
    $75 per sheet
95. Quantity
    -- Select One --12345
96. Fee Total
98. Sewer Line
    $75 per sheet
99. Quantity
    -- Select One --12345
100. Fee Total
102. Total Plan Review Fee
104. Total Permit Fee + Total Plan Review Fee
106. Work to commence within 90 days or permit becomes void. Permit expires in 180 days.
     
     Call 480-488-3686 to arrange for inspection 24 hours in advance.
     
     Final inspection is required upon project completion.
108. Amount Paid
109. By Whom
110. Receipt Number
112. Date Paid
     Date Paid
113. Cash Deposit Amount
114. Bond Amount
116. Expiration Date
     Expiration Date
117. Certificate of Insurance Attached
119. Approved
     Town of Carefree
120. Approval Date
     Approval Date
121. Permit Number
123. Date Work Completed
     Date Work Completed
124. Date Bond / Cash Deposit Refunded
     Date Bond / Cash Deposit Refunded
Leave This Blank:


126. 1. Receive an email copy of this form.
127. Email address

     This field is not part of the form submission.

128. Submit

* indicates a required field