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*

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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

Drag and drop files here or

Town / City

Select or enter value

Street Name

From Address Number

To Address Number

Are Supplies Required?*

Select or enter value

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)

Pickup Time*

Select

Comments

Optional

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