R. O. W. Permit application



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City of Lee's Summit


PUBLIC WORKS DEPARTMENT/ENGINEERING DIVISION

220 SE Green Street

lee's summit, missouri 64063

(816) 969-1800 FAX 969-1809



R.O.W. PERMIT APPLICATION
User Information
1. Please Select A User Name: ______________________________

2. Please Select A Password: _______________________________


Company Information
1. Company Name: _________________________________________

2. Contact Person: _______________________________________

3. Address: ______________________________________________

4. City: _________________________________________________

5. State: ________________________________________________

6. Zip: __________________________________________________

7. Phone: ______________________________________________

8. Fax: __________________________________________________

9. E-mail: _______________________________________________
Billing Information
1. Contact Person: _______________________________________

2. Address: ______________________________________________

3. City: _________________________________________________

4. State: ________________________________________________

5. Zip: __________________________________________________

6. Phone:________________________________________________


Excavation Permit Information
Job Location
1. Location Address: ____________________________________

2. Nearest Cross Street: _________________________________

3. Subdivision Name: _____________________________________

Work Schedule

1. today’s date: ________/________/________

2. date work will begin: _______/________/________

3. date work will be completed: _______/_______/_______


Description Of Work
1. General Description of Work: __________________________

2. Utility Subcontracting For: ___________________________

3. Bill will be sent to applicant


  • A sixty dollar fee per permit unit will be billed to the appropriate party.


Excavation Information
length of Excavation (ft): __________ Number of Pits: __________

Width of Excavation (ft): __________ LENGTH of Bore (ft): __________

Number of Sidewalk Cuts: __________ NUMBER of Bike-path Cuts: _______

Number of Street Cuts: ____________ Number of Driveway Cuts: _____



Number of Poles: ___________ Street Crossings ____________

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