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2. PRIOR TO STARTING WORK
   Call Pat Ferarra, DPW Superintendant at 201-392-3500 x6001 - Restoration requirements, inspections, other site issues. For Scheduling Jobs, call JOBS-4-BLUE at 877-425-8330. PO Mark Radoian, Fort Lee Police Dept Traffic Division at 201-592-3515. Call for inspection: 201-592-3632; Call for Utility Markout: 800-272-1000.
4. Applicant Name*
5. Email Address*
7. Owner of Property*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Contractor's Phone Number*
16. Emergency Number*
18. Type of Permit*

    1. Road Open
    2. Sidewalk
    3. Combined Sewer Connection

    1. Utility Company
    2. Soil Movement
    3. Sanitary Sewer Connection

    1. Storm Sewer Connection
    2. Sewer Disconnection
20. Location in the Borough of Fort Lee (State location exactly in reference to intersecting streets, bridges or existing landmarks. Give street number if possible.)*
22. Decription of What the Opening is for (Give type of street surface, including information location of opening with respect to far side, near side, sidewalk area, tunnel, etc.)*
24. Area Size*
26. Start Date*
27. Completion Date*
29. Restoration to be Performed by*
31. Fees and Timelines

    1. Non-Emergency Permits may be issued from December 1 to March 1 with the approval of the DPW Director.
    2. Permits issued from December 1 to March 1 shall be considered "Conditional."
    3. Plating is permitted only with the approval of the DPW Director and the FLPD.
    4. This permit may be deemed "Inactive" during inclement weather and/or as directed by the DPW Director or FLPD.
    5. The Borough assumes no liability for delays or any issues that arise during construction.

    Fees: Per ordinances 95-28 - 95-29 - 95-30
33. Bond for Inspection*
34. Permit Fee*
36. Time Period for Backfilling
    Time for permanent repairs must be within 4 months of time of completion of temprary backfilling. Time for Public Utility Companies must be 5 days after notice from road superintendent. NOTICE: no opening will be permitted between December 1 and March 1 except in case of emergencies. Notice of emergencies must be given to the police and the road dept.
40. FOR BOROUGH USE ONLY:
41. Inspected By (Signature)
42. Refund of Depost Approved By (Signature)
44. Return Original Permit on Applying for Refun of Cash Deposit (date and DPW Director signature)
46. Fee
47. Inspection Bond
51. 
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52. Print Only

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