2. 
4. Curb and Sidewalk Permit Application
6. Property Address*
8. Property Owner's Name*
10. Property Owner's Address*
12. Property Owner's Phone #*
14. Concrete Contractor's Name
16. Concrete Contractor's Address
18. Concrete Contractor's Phone #
20. Lot Type*

    1. Corner
    2. Interior
22. Type of installation*

    1. Curb Only
    2. Sidewalk Only
    3. Curb & Sidewalk
24. If Curb, linear feet
25. If Sidewalk, square feet
27. Is application part of a street reconstruction program?*

    1. Yes
    2. No

    If yes, no fee will be required
28. Are there any signs in the work area?*

    1. Yes
    2. No

    Street signs, stop signs, speed limit signs, no parking signs, etc.
29. Is a PennDOT Road Occupancy Permit required? (see below)

    1. Yes
    2. No

    Required when working within a PennDOT right-of-way
31. Attach PennDOT road occupancy permit here
33. NOTE: If proposed work will occur in or along the roadway the Borough will attach a copy of a traffic control plan to the permit.
37. The proposed work is authorized by the owner in fee and I as applicant, am authorized to make this application. I acknowledge that this application is conditional upon complying with all applicable Federal and State laws and regulations. I further agree that I will not allow the public sidewalk to be impassable and blocked to pedestrian traffic for more than seven (7) days.
39. Name*
    By entering your name and date above, you are signing this form and agreeing to all terms and conditions of this application.
40. Date*
    Date
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field