Excavation Permit Application

ALLIANCE FOR CONTRACTORS

EXCAVATION PERMIT APPLICATION

MEDIUM PRIORITY

APPLICANT INFORMATION

Company Name:   License Number:  
Contact Person:   Phone Number:  
Email Address:   Emergency Contact:  
Mailing Address:  

PROJECT DETAILS

Project Location:  
Project Description:  
Proposed Start Date:   Estimated Completion:  
Work Hours:   Days of Week:  
Excavation Depth:   Excavation Area (sq ft):  

EMERGENCY NOTIFICATION REQUIRED

CALL 811 BEFORE YOU DIG - Utility location must be verified at least 48-72 hours before excavation begins. Failure to comply may result in permit denial and legal liability.

811 UTILITY LOCATION VERIFICATION

811 Ticket Number:   Date of 811 Call:  
Locate Valid Until:   Private Locates Required: ☐ Yes ☐ No

Alliance Integration Service

811 Utility Location Coordination: Our team provides comprehensive utility location verification services, including coordination with local utility companies, private locate services, and documentation management to ensure full compliance with excavation safety requirements.

Utility Verification Checklist:

  • Electric utilities marked
  • Gas utilities marked
  • Water/Sewer utilities marked
  • Telecommunications marked
  • Cable/Internet marked
  • Private utilities identified
  • Utility conflict areas identified
  • Hand digging areas designated

TRAFFIC CONTROL PLAN

Traffic Impact: ☐ Lane Closure ☐ Sidewalk Closure ☐ Full Road Closure ☐ No Impact
Traffic Control Company:  
Flaggers Required: ☐ Yes ☐ No   Number of Flaggers: _____

Alliance Integration Service

Traffic Control Planning: We provide complete traffic control planning services including permit coordination, signage specifications, flagger certification, and coordination with local transportation authorities for seamless project execution.

Required Traffic Control Devices

  • Warning signs
  • Barricades
  • Traffic cones
  • Arrow boards
  • Temporary signals
  • Reflective devices

Documentation Required

  • Traffic control plan drawing
  • Detour route map
  • Emergency access plan
  • Public notification plan
  • Flagger certification
  • Equipment specifications

SAFETY PROTOCOLS & SHORING REQUIREMENTS

Competent Person:   OSHA 30 Certified: ☐ Yes ☐ No
Shoring Required: ☐ Yes ☐ No Shoring Type: ☐ Trench Box ☐ Slope ☐ Benching ☐ Other

Alliance Integration Service

Safety Consultation: Our certified safety professionals provide on-site consultation for excavation operations, shoring system design, and OSHA compliance verification to ensure maximum worker protection and regulatory adherence.

Safety Requirements

  • Daily safety inspections
  • Atmospheric testing (if required)
  • Emergency evacuation plan
  • First aid/medical plan
  • Personal protective equipment
  • Confined space procedures
  • Equipment inspection logs

Shoring System Requirements

  • Engineered shoring design
  • Soil analysis report
  • Installation procedures
  • Daily inspection checklist
  • Removal procedures
  • Load capacity calculations
  • Manufacturer specifications

ENVIRONMENTAL PROTECTION MEASURES

Stormwater Permit Required: ☐ Yes ☐ No SWPPP Available: ☐ Yes ☐ No ☐ N/A
Wetlands Present: ☐ Yes ☐ No Contaminated Soil Possible: ☐ Yes ☐ No

Alliance Integration Service

Environmental Compliance: We provide comprehensive environmental compliance assistance including permit acquisition, monitoring services, and restoration oversight to ensure full environmental protection and regulatory compliance.

Environmental Protection Checklist:

  • Erosion and sediment control measures
  • Dust control procedures
  • Noise control measures
  • Waste disposal plan
  • Spill prevention and response plan
  • Air quality monitoring (if required)
  • Water quality protection
  • Wildlife protection measures

PUBLIC SAFETY COMPLIANCE

Public Notification

  • Advance notice to residents
  • Business notification
  • Emergency services notification
  • Utility company coordination
  • Public posting of permits

Emergency Preparedness

  • Emergency contact list
  • Utility emergency numbers
  • Medical emergency procedures
  • Fire department notification
  • Evacuation procedures

RESTORATION REQUIREMENTS

Surface Type: ☐ Asphalt ☐ Concrete ☐ Gravel ☐ Grass ☐ Other: _______
Restoration Timeline:   Warranty Period:  

Alliance Integration Service

Restoration Monitoring: Our quality assurance team provides comprehensive restoration monitoring services, including progress tracking, compliance verification, and warranty management to ensure complete site restoration to original conditions.

Restoration Standards:

  • Site cleaned to original condition
  • Proper backfill and compaction
  • Surface restoration to match existing
  • Landscaping replacement (if applicable)
  • Final inspection and approval
  • One-year warranty on restoration work
  • Performance bond (if required)

INSURANCE & BONDING

General Liability: $ __________ Policy #: __________
Workers' Compensation: $ __________ Policy #: __________
Performance Bond: ☐ Required ☐ Not Required Amount: $ __________

PERMIT FEES

Base Permit Fee: $ __________
Traffic Control Fee: $ __________
Inspection Fees: $ __________
Total Fees: $ __________

CERTIFICATIONS & ACKNOWLEDGMENTS

I hereby certify that all information provided in this application is true and accurate. I understand that any false information may result in permit denial or revocation. I agree to comply with all applicable laws, regulations, and permit conditions.

  • I have contacted 811 for utility locates
  • I will maintain all required insurance
  • I will comply with all safety regulations
  • I will restore the site to original condition
  • I will notify the city of any changes to the work
  • I understand permit fees are non-refundable

Applicant Signature

Date: ___________

City Inspector

Date: ___________

Permit Official

Date: ___________

ALLIANCE FOR CONTRACTORS - Excavation Permit Application
For assistance with permit applications and compliance services, contact Alliance Integration Services