2. 
3. Temporary Use of Public Right-of-Way Permit Application
   Please allow up to 14 days for the processing of this application
5. By submitting this permit application, the applicant swears and certifies that:
   • The applicant will obtain utility locates before digging, trenching, or boring in the right-of-way;
   • The applicant understands that no work in the right-of-way, other than obtaining utility locates, is permitted until a Temporary Use of Public Right-of-Way Permit is affirmatively issued;
   • The applicant has read Chapter 30, Articles 4 of the Code of Ordinances for the City of Manhattan and understands the regulations therein;
   • The applicant will restore the right-of-way to city specifications;
   • The applicant will notify the city when the use of the right-of-way is complete;
   • The applicant will maintain traffic control devices in compliance with the Manual of UniformTraffic Control Devices (MUTCD) throughout the project;
   • The applicant will meet the conditions of any applicable KDOT permit;
   • The applicant will obtain approval from the City of Manhattan Parks and Recreation Departmentbefore digging, trenching, or boring within ten feet of any tree in the right-of-way; and
   • The applicant understands that the permit holder is responsible for covering meters with meter bags or posting no parking signs associated with this permit at least 24 hours in advance.
   • The city will not tow vehicles parked in violation of either the meter bags or no parking signs. Towing vehicles in association with this permit is the sole responsibility of the permit holder.
   • The permit holder is liable for any and all claims that involve vehicle removal. The city will refer any and all concerns/complaints by citizens to the permit holder.
   • The permit holder is responsible for taking reasonable steps to appropriately handle the concerns/complaints.
7. Applicant has read the above and understands*
11. APPLICANT INFORMATION
13. Contact Person:*
14. E-Mail Address:*
15. Business Name:*
17. Preferred Phone:*
18. Mailing Address: Street*
19. City*
21. State*
22. Zip*
23. 24-Hour Phone:*
25. Company with City Agreement:*
26. Agreement #:*
28. List of Subcontractor(s)*
    List to Include: Company Name, Contact Person, Business and Afterhours Phone Number, Email Address for Contact Person
30. LIST DATE(S) OF REQUESTED USE OF RIGHT-OF-WAY BELOW
    Each permit application may include facilities work to be performed by the applicant within an area up to 400 lineal feet, or 160,000 square feet. Facilities work exceeding 400 lineal feet or 160,000 square feet will require additional permit(s)
32. Date
    Date
33. Time
    Time Start Time

    —

    Time End Time
34. Location of Use
36. Date
    Date
37. Time
    Time Start Time

    —

    Time End Time
38. Location of Use
40. Date
    Date
41. Time
    Time Start Time

    —

    Time End Time
42. Location of Use
44. OR Date and Time Span
    OR Date and Time Span Start Date

    OR Date and Time Span Start Time

    —

    OR Date and Time Span End Date

    OR Date and Time Span End Time
46. Location of Use
48. Is applicant the owner of the adjoining property*

    1. Yes

    1. No

    (If no, attach the owner's written permission below)
50. Owner's written pemission
52. Describe the use of this right-of-way
54. If additional space or documentation is needed, upload documents here
56. QUESTIONS FOR APPLICANT
58. Do you need meter bags?

    1. Yes

    1. No
59. If yes, how many?
61. Do you need "no parking" signs?

    1. Yes

    1. No
62. If yes, how many? (1 sign per 30 feet)
64. Note: You will be contacted when meter bags and/or "no parking" signs are ready to be picked up. A $1.00, non-refundable, charge per bag/sign is due before materials can be received.
66. Is this project being undertaken on behalf of the City of Manhattan?*

    1. Yes

    1. No
67. If yes, who is your main contact person with the City on this project?*
69. Will you be digging, trenching, or boring within ten feet of any tree in the right-of-way?*

    1. Yes

    1. No
70. Are any street lane closures anticipated?*

    1. Yes

    1. No
72. Are any full/partial sidewalk closures anticipated?*

    1. Yes

    1. No
73. Will street lane closure necessitate bus re-routes?*

    1. Yes

    1. No
75. Will you be installing any above-ground permanent fixtures, equipment, or markers?*

    1. Yes

    1. No
76. Will you be making any pavement cuts (streets, curbs, gutters, sidewalks, etc.)?*

    1. Yes

    1. No
78. Is the work located within any historic district or environs?*

    1. Yes

    1. No
80. PLEASE INCLUDE:
82. Fees and Charges (Effective January 1, 2021)
    Once permit is approved, applicant will be emailed an invoice detailing all charges and fees, with a minimum $200.00 Application Fee (non-refundable). The email will provide a link for online payment. Once payment is accepted, the permit will be ready for pickup at Customer Service Desk at City Hall the next business day
84. Certificate of general liability insurance in the amount of $1,000,000 with City of Manhattan listed as certificate holder*
86. $50,000 Maintenance/performance bond*
87. MUTCD compliant traffic control plan if the activity will impact pedestrian or vehicular traffic in any way
89. Copy of KDOT permit if applicable
90. Photos/illustrations of any above-ground fixtures or equipment
92. Scale drawings showing the location of existing utilities and location of any new installations.
93. Site plan of the utilized right-of-way*
95. eSignature*
    I understand and agree that by typing my name above I am providing a legal signature on this application for the right-of-way permit.
96. Relationship to Applicant*
    Describe your relationship to the applicant.
100. Today's Date*
     Today's Date
101. * Application cannot be accepted without a signature.
105. OFFICE USE ONLY
108. Permit reviewed by:
113. City services needed:
118. THIS PERMIT SHOULD BE PROMINENTLY DISPLAYED WHERE THE PUBLIC RIGHT-OF-WAY IS BEING USED OR BE AVAILABLE FOR REVIEW BY ANY OFFICER OR EMPLOYEE OF THE CITY OF MANHATTAN UPON DEMAND. THIS PERMIT MAY BE REVOKED OR SUSPENDED AS PROVIDED BY LAW.
Leave This Blank:


120. 1. Receive an email copy of this form.
121. Email address

     This field is not part of the form submission.

122. Submit Submit and Print

* indicates a required field