Highway Access Permit (ROW Work) 19 VSA 1111

Right-of-Way Work Permit (19 VSA 1111)

Please fill the form below to apply for review of your project.
Your Name: *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Include description of work to be completed:
Have you flagged the work site? Staking or flagging the work site at the shoulder of road is required as part of a complete application.

Yes No
When are you planing on work starting (estimated or use "ASAP")?

Month Day Year
What will be the use of the proposed work? *

Single-family or Two-family home driveway Commercial, 3-family or more dwelling, or mixed uses Agricultural uses only / field access Utility work Other
Questions/Comments:
Upload sketch of project area with accurate measurements to physical locations in the field - such as the closest telephone pole, culvert or a side road or driveway.

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Right-of-Way Work Permit (19 VSA 1111)