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Market St Smithfield, NC 27577  \nP.O. Box 761, Smithfield, NC 27577 Phone: 919-934-2116  \nFax: 919-934-1134  \nRight-Of-Way Encroachment Application  \n1. Applicant Information  \n\n| Owner or County: |  | Address: |\n| --- | --- | --- |\n| Phone: | Fax: |  |\n| E-mail: |  |  |\n| Field Contact Name: |  | Field Contact Phone: |\n\n2. Contractor Information  \n\n| Name: |  | Address: |\n| --- | --- | --- |\n| Phone: | Fax: |  |\n| E-mail: |  | License \\#: |\n| Field Contact Name: |  | Field Contact Phone: |\n\n3. Project Information  \n\n| Address or Location: |  |\n| --- | --- |\n| Type of Work (check all that apply):\u003Cbr>( ) Telephone ( ) Gas ( )Electric ( ) Water ( ) Sewer ( )Storm Drain ( ) Cable ( ) Other: |  |\n| Detailed Description of work to be done: |  |\n| Estimated Start Date: | Estimated End Date: |\n| Estimated Value of Work (Value of any grading, concrete work, paving patching, site restoration, etc. shall be provided by the applicant – List all items and associated costs as an attachment) |  |\n\n\n|  | Asphalt Street | Concrete Street | Curb | Sidewalk | Alley | Other: |\n| --- | --- | --- | --- | --- | --- | --- |\n| Excavation\u003Cbr>L x W x D: |  |  |  |  |  |  |\n| Surface Cuts L x W: |  |  |  |  |  |  |\n\n\n| List Streets, Lanes, and/or Sidewalks that will be closed during construction: | Estimated Closure Date | Duration |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n\nList of Attachments:  \nI (we) hereby agree to be bound by the provisions of this permit, all applicable State and Federal Laws, all Town of Smithfield Standards, Specifications, Ordinances, and any other applicable regulatory requirements. I (we) agree that this permit shall become invalid, if during the performance of the work, a violation of the above occurs. Should a violation occur, and corrective actions directed by the Town of Smithfield is not performed, I (we) understand that this permit shall be deemed “cancelled” and corrective actions will be performed and/or all improvements will be removed by a Third Party at the permit holder’s sole expense.  \nApplicant Signature:   Date:   Print Name:   Title / Authority:    \nStandard Provisions:  \n1. The Towns reserves the right to require any additional information he so desires, including design standards, drawings, and any other pertinent data.  \n2. The Town will respond to the permit application within three (3) consecutive working days. Street cuts require additional permitting but in emergency situations that threaten public health and safety are allowed without a permit; however, a permit application shall be submitted the next business day.  \n3. A site plan is required for new construction and for revisions or relocations of existing infrastructure  \n4. Applicant is responsible for locating all existing utilities and is responsible for any repairs to existing utilities damaged asa result of the construction activities.  \n5. A surety bond is required for work in the right of way equal to 1.25 x the valuation of the work unless waived by the Public Works Director.  \n6. A copy of the approved permit must be kept available on the job site for the duration of work  \n7. All surfaces disturbed by the construction activity shall be restored or re-installed to pre-construction conditions.  \n8. Sidewalk and curb and gutter shall be removed to the nearest joint if within five (5) feet.  \n9. All construction activities shall be performed in a safe manner. All construction areas shall be continuously maintained in a safe manner, and shall not create any public hazards.  \n10. The permittee shall be responsible for the repair of any deficiencies in the right-of-way caused by the construction for two years after completion date. Failure to respond within 48 hours will authorize Town forces to make necessary repairs and back charge those repairs to the permittee. Emergency conditions will be repaired by the Town immediately and back charged.  \n11. Asphalt and concrete restoration shall be compl","cbCaiugP5pM5zGoE","https://ap.wps.com/l/cbCaiugP5pM5zGoE","pdf",207062,"English","# Applicant Information\n# Contractor Information\n# Project Information\n# Attachments and Applicant Agreement\n# Standard Provisions\n# Special Provisions\n# Work and Inspection Authorization\n# Office Use Only","[{\"question\":\"What information is required from the applicant on the Right-of-Way Encroachment Application?\",\"answer\":\"The form requests owner or county, address, phone, fax, e-mail, field contact name, and field contact phone. It also requires applicant signature, date, and printed name with title/authority.\"},{\"question\":\"Which project details must be provided for the proposed right-of-way work?\",\"answer\":\"Applicants must provide the address or location, work type selections (e.g., telephone, gas, electric, water, sewer, storm drain, cable), a detailed description, estimated start and end dates, estimated work value, and measurements for excavation and surface cuts.\"},{\"question\":\"What standard requirements govern construction and restoration after work in the right-of-way?\",\"answer\":\"The standards require safe work practices and continuous maintenance of safe conditions, locating and repairing any damaged existing utilities, restoring disturbed surfaces to pre-construction conditions, meeting NCDOT traffic control device requirements, and completing asphalt and concrete restoration within the specified working-day timelines.\"}]","Right-of-Way Encroachment Application - Form | PDF",1789535898]