Utility Pavement Cut or Bore Permit Application

City of Bethany
Application for Utility Pavement Cut or Bore
Complete the electronic form or print and complete a paper application below. Paper applications must be completed in INK. Use back or additional sheets if necessary.  If submitting plans, provide TWO copies. Submit applications via email to Construction.Application@bethanyok.org , fax at (405)789-6093, or in person at 6700 NW 36th Street, Bethany, OK 73008. Contact Community Development at (405)789-6005 for questions. Permits can be paid for by phone with a Visa or Mastercard, or at our drive-thru window with a credit card, cash, or check made out to the City of Bethany. 
Click here to view and print a paper application.
Information
Location of Work (Attach Sketch) :


Company Name:

Phone:

Address: 

Contact Name:

Phone:

Work to be done
Date to Start Work:

Approximate Dimension:
Length

Width
Surface Type
 P.C. Concrete
 Asphalt
 Other:
Utility contact information (If utility contractor sub)
Business Name:

Business Phone:

Business Address:

Note
Request is hereby made for permit to cut and replace paving at the location shown. We agree to inform the City of Bethany 24 hours in advance of commencement of construction operations and to follow standards as established and attached to this application.

Scheduled date for pavement cut repair is

I declare, certify and verify under penalty of perjury that the foregoing is true and correct to the best of my knowledge.

Signature of Applicant:

Date:

     
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