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Hard Surface Application

  1. StormLakecmyk-nobackground
  2. Hard Surface Permit Application
  3. Street
  4. Street, City, State, Zip Code
  5. wing
  7. By my signature below I agree that I will call Iowa One Call at 1-800-292-8989 prior to any digging activities related to this project. I also agree that the information provided above is correct to the best of my knowledge. I understand that street cuts and curb cuts can only be made by the City of Storm Lake and that I may be charged a fee for this service which must be paid prior to any work being done by the City. I also understand that all repairs to the street cuts and curbs must be done in accordance with City specifications by either the City of Storm Lake or a qualified contractor. Should I elect to use grinding as an alternative to a curb cut I agree that all grinding activity must be completed by a city approved contractor. I agree to make myself available for inspections as required by the City and to call for inspections at least 24 hours in advance of when they are needed.
  8. * A separate application is required for curb cuts.
  9. For City Use Only
    THIS PERMIT AUTHORIZES CONSTRUCTION OF IMPROVEMENTS SPECIFIED. By signing above, the applicant hereby agrees, in consideration of the issuance of this permit, to assume responsibility for and to hold the City harmless in regard to any and all claims of injury or damage arising from the acts or omissions of the applicant or his/her agents while acting under the authority of this permit. The applicant further agrees to comply with the provisions of the Code of the City of Storm Lake, Iowa and 29 CFR Part 1926.650, 651 and 652 as adopted by the Iowa Division of Labor.
  10. City of Storm Lake Building Official ~ 620 Erie Street ~ Storm Lake, IA 50588 ~ 712-732-8002
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  12. This field is not part of the form submission.