Form Center

2. Road Opening Permit (April 15-November 15)
   A Road Opening Permit is required if working on City Property. 24 Hour notice must be given to Inspector.
4. Fee
   $100.00 (Trench permit fee is included)
8. Company Info:
10. Company Name*
11. Business Number*
13. Contact Name:*
14. Contact Cell Phone*
16. Address*
17. Email Address*
19. City*
20. State*
21. Zip Code*
23. Project Info:
25. Project Address*
27. Project Description*
29. Trench Length (ft)
30. Trench Width (ft)
31. Approx Date of Completion*
33. Dig Safe Number*
37. A Road Opening Permit is required if working on City Property/Street/Sidewalks*

    1. I Understand
39. Contractor who will be doing project must have a cash security with the City of Gardner*

    1. I Understand
41. Contractor must notify DPW for inspection within 24 hours after completion of trench resurfacing*

    1. I Understand
43. Contractor is responsible for all trench repairs for two (2) years from last date of permit.*

    1. I Understand
45. Trenches in Pavement must be saw-cut prior to excavation. All trenches will be blacktop within twenty-four (24) Hours of excavation. If trench found to be deficient, contractor will be notified by the DPW. Contractor will have 10 calendar days from the time of notification to make repairs. If repairs are not made in this time period, trench will be repaired and paid with cash security funds. Cash Security must be at full capacity prior to issuance of a Road Opening Permit.*

    1. I Understand
47. The undersigned has read and understands the City of Gardner’s City Specifications, Ordinances, and Regulations and agrees to abide by them. This permit is not transferable.
49. Electronic Signature*
    By typing my name in my box, I certify that the above information is accurate and correct.
Leave This Blank:


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

    This field is not part of the form submission.

56. Submit

* indicates a required field