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How many total days for said work to be completed?
Where will your excavation be taking place? (Mark all that apply).
What is the size of your excavation or cut?
Mark all that apply.
Write the length, width, and depth of your excavation size. If you are excavating in more than one area, for example sidewalk AND apron, label which excavation size belongs with which area of excavation.
If you have a PDF of a traffic control plan, excavation plan, site plan documents, etc., you may upload them here.
The applicant herein shall comply with Section 9.21 of the City of Green Bay Municipal Code of General Ordinances and also shall assume all responsibility for any claim of damage against the City caused by such excavation.
The work is to be done as directed in Section 9.21 of the City of Green Bay Municipal Code of General Ordinances
which requires all excavations made in paved areas in the public right-of-way shall meet the construction methods and site
restoration in accordance with applicable parts of the City of Green Bay Standard Specifications and Construction Standards for
Public Works Construction, current edition. The permittee shall be responsible for all costs associated with maintaining the
The applicant is liable for the full costs of permanent repairs and will be billed for these costs.
The applicant hereby certifies that he has a Bond and Certificate of Insurance filed with the City Risk Management Department
in accordance with Section 9.21(2) of the City of Green Bay Municipal Code of General Ordinances.
The applicant hereby agrees that he will sign and barricade the work site according to the latest Wisconsin Department of
Transportation Manual of Uniform Traffic Control Devices and is liable for all damages for failure to erect and maintain suitable
barricades, signs, and lights.
As a condition of this permit (if approved), you are required to notify the pipeline operator immediately if your work damages a pipeline and to
call 911 or other local emergency response number immediately if the damage results in a release of natural gas or other
hazardous substance or potentially endangers life, health, or property.
I, as the applicant, understand that before submitting this excavation permit request form that appropriate and valid bond and insurance are required to be on file with the City of Green Bay Risk Management Department. Additionally, I understand that if my firm is constructing a sidewalk, curb, or apron in the City of Green Bay Right-of-Way that a Sidewalk Builders License must be issued from the City of Green Bay. I understand that all of these factors will be verified by Public Works staff before my permits are sent for review and potential approval. I understand that this form is a request only and does not authorize me to begin work until I receive an email with a link to download my permit documents if they are approved.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
END OF APPLICATION. Click "Submit" so that the Department of Public Works can review your permit request. If your permits are approved, you will receive an email notification within 3 business days with a link to download your approved permit documents.
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