TOWN OF NEWTON
PERMIT FOR SIDEWALK CONSTRUCTION AND REMOVAL

Owner's Name:*

Owner's Address:*

Owner's Telephone Number: (include area code)*

Contractor's Name:*

Contractor's Address:*

Contractor's Telephone Number: (include area code)*

Work Site:*

Block:*

Lot:*

Estimated Cost of Work:*

Work Date(s):*

Application to:

Remove Construct

Remove & Construct

Linear Feet of Sidewalk:

Type of Sidewalk Material:

Application to:

Remove Construct

Remove & Construct

Linear Feet of Curb/Gutter:

Application to:

Remove Construct

Remove & Construct

Linear Feet of Driveway Apron:

Existing Sidewalk Surface:

Purpose of Removal:

A plan of the proposed work including the exact location with respect to a street intersection (or fixed object) with its width and relationship to the grade of the street and the adjacent property and in the case of a driveway apron its slope or pitch shall be submitted with this application. The undersigned agrees to indemnify and save harmless the Town of Newton from any and all liability in conjunction with said work. The undersigned agrees to repair and promptly replace any damage to existing curb or street surface resulting from removal of the sidewalk. If such damage is not repaired within ten (10) days, the Town may make the repairs and charge the undersigned for reasonable cost of repairs, which the undersigned hereby agrees to pay. It is expressly understood that if this curb is ever replaced, it shall be done at the full expense of the property owner. Once the Town participates in curb construction, and the curb is removed, the Town will not again participate in the curb construction costs.

Signature of Applicant:

Printed Name:*

In accordance with §266-37 a Performance Guarantee may be required by the Director. The information below is to be filled out by Town of Newton staff only.

Date Received:

$15 Fee Payment:

Cash

Check

Check #:

By:

Approval Date:

Approved By:

Permit #SW

Performance Guarantee:

Required

Waived