Permit Application Form

Permit Request Form

Please Fill Out the Form Below to Submit Your Permit Request!
Name and Company

First and Last Name of Contact for PermitCompany
E-mail
example@example.com
Phone Number
(000) 000-0000Format: (000) 000-0000.
Proposed Start Date of Work

MonthDayYear
Date
Proposed End Date of Work

MonthDayYear
Date
Scope of Work (Include dimensions in feet W x L)
Example: 10 foot wide by 5 foot long trench in street for utility repair
Provide all streets and blocks that the work will take place (i.e. 500 block of W 5th St. or 1100 to 1600 blocks of Main St.)
Example: 500 block of W 5th St. or 420 Little Elm Rd.
List any and all subcontractors that may be working under your permit (Put "None" if no other contractors will be performing work under your permit)
Provide your Building Permit or Site Plan number (if applicable)
Provide your Utility Coordination Case (UCC) Number (if applicable)
Provide your General Permit Number (if applicable)
Are you already a licensed contractor in the jurisdiction that you are needing the permit in? This means that a copy of your current bond and insurance are on file with that jurisdiction.
Letter of Authorization (You must list LACA Traffic Solutions LLC on your Authorized Agent Form (AAF) OR provide a letter in writing authorizing LACA Traffic Solutions to pull a permit on your behalf)

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Traffic Control Plan (TCP) (Note: All permits will require a TCP. If you have one, please submit it with this submission. If a TCP is not available yet or you need assistance with figuring out what TCP is needed, leave this blank and we will reach out to you to discuss further)

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Utility Plan (REQUIRED for EX permits)

You can share certificates, diplomas etc.
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Normal Service or Expedited Service? Normal service means that we will submit the permit application on your behalf within five (5) business days of receiving this form. Expedited service means that we will submit your permit application within 24 business hours of receiving this request. *Note: This does not guarantee your permit will be approved in these timeframes*
If you would like the invoice for payment to go to someone else to pay (i.e. your finance department), please provide the name and email to send the invoice to. Otherwise, the invoice will be sent to the email provided above.

First and Last NameEmail
I agree that all the information provided is true and correct to the best of my knowledge at time of submittal. (Please note: Incorrect information may result in delays in obtaining a permit).
Fees: Fees are dependent on the type of permit needed. This form collects all the information and a member of LACA Traffic Solutions, LLC will provide an invoice for the permitting services provided. Contractor will be responsible for paying for all fees prior to obtaining a permit. The first invoice will consist of the Permit Fee through LACA Traffic Solutions, LLC. The second invoice will consist of any Right-of-Way (ROW) Usage fees or other government fees added. An approximate amount will be provided by LACA Traffic Solutions, LLC.
Once this form is submitted, we will review this and reach out to you if further information if needed.

For information or assistance, please reach out to permits@lacatraffic.com to contact one of our teammembers to assist you.
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Permit Request Form