PERMIT TO WORK WITHIN THE COUNTY RIGHT-OF-WAY

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Rev. 4/09/15 County of Hawaii DEPARTMENT OF PUBLIC WORKS – ENGINEERING DIVISION Permit to Work within the County Right-of-Way INSTRUCTIONS TO THE APPLICANT 1.The Applicant shall provide three (3) sets of plans to the Department of Public Works. The plans shall include the dimensions of work relative to the road and property lines, type of asphalt or concrete pavement, swales (or other drainage devices) and any other relevant information. 2.All work shall be in accordance with Chapter 22 – County Streets, of the Hawaii County Code, and as shown on the approved plans. 3.As required, all work shall be performed by a licensed contractor. The contractor may sign the permit application on behalf of the permittee/owner. 4. required, the Applicant shall provide a copy of DCAB’s “Document Review” confirmation letter with the application. A copy of DCAB’s form and associated fee schedule can be found athttp://health.hawaii.gov/dcab/files/2013/01/HRS-103-50-Transmittal-Form-Dec-2012.pdf. 5.If not already on file with the Department of Public Works, the contractor shall provide a certificate of insurance specifically naming as an additionally insured, the County, its officers, representatives, employees, and agents as required by Hawaii County Code. 6.The issued permit will become null and void if the authorized work is not completed within one (1) year of the issuance date. 7.If you are closing a road, at least two (2) weeks before the scheduled closure, complete an application form and drop it off at the Police Department’s Traffic Services. (Application Forms are available from Traffic Services 961-2227 or 961-2226). Attach a map of the area to the application. The Police Department will route the application through all applicable County agencies for approval. Countyof Hawai‘i is an Equal Opportunity Provider and Employer