RWA Paving/Resurfacing Online Request Form

To the Requestor

Thank you for completing this form to request paving or resurfacing assistance. In the comments section at the bottom of this form, please include the purpose of the project you are requesting.

Company / Agency

Contact Name

Contact Department

Contact Phone Number

Contact Email

Paving Contractor (if different)

Paving Contractor Name

Paving Contractor Phone Number

Permits / CBYD

According to the Call Before You Dig (CBYD) excavators manual, page 2: 4, you must submit requests if you are using mechanized equipment, even if you are only excavating a few inches or just surface grading. You must call in information if you move material or plan to drill or drive anything into the ground. Please provide the RWA with your CBYD ticket number below.

Call Before You Dig Ticket Number

Road Opening Permit Number

Locations

If doing work on a single street, please provide the name of the street and the area to be paved. If doing work on more than one street, please upload a file with list of street names and the “To” and “From” information.

File Upload

Drop your files here

Town / City

Street Name

From Address Number

To Address Number

Are Supplies Required?

Gate Cover: Riser-1" (Part ID # GA100)

Quantity

Gate Cover: Riser-2" (Part ID # GA200)

Quantity

Gate Cover: Cap 7-1/2” (#69)

Quantity

Gate Cover: Top Section 17” (#55)

Quantity

Pickup Contact Name

Pickup Contact Phone Number

Preferred Pickup Date

(Allow 3-5 business days)

mm/dd/yyyy

Pickup Time

Comments

Optional

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