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Public Way Disturbance Permit

  1. Public Way Disturbance Permit Application

    Prior to initiating any excavation or other type of work that will disturb any public street or way, a Public Way Disturbance Permit shall be obtained. Such a permit is required due to the permitting process for work within public ways established by Section 212-14 (E) of the Village of Elm Grove Code of Ordinance. The Director of Public Works must approve the Public Way Disturbance permit. 

    All permits submitted for review must include, at a minimum, payment of a three hundred dollar ($300) base fee. In the event that the proposed work will be done within a paved surface area, a restoration fee of $40 per square yard (of disturbed area) shall be submitted along with the base fee. A slurry backfill shall be used for roadway restoration, in accordance with Section 212-14 (D) (3) of Village Code. 

    Should multiple borings be used to disturb any paved surface area, each individual boring shall be considered as one square yard. Should the proposed work be located within a grassed surface area (i.e. a ditched area adjacent to a paved roadway), a restoration fee of $2 per lineal foot (of disturbed area) shall be submitted along with the base fee.


    If directional boring is a component of the proposed work to be performed, permittee shall televise any and all adjacent sanitary or storm sewers and provide copy to Public Works Director prior to issuance.

  2. Pre-Submission Fee

    A.) Base Permit Fee: $300.00

    B.) Total square yardage of disturbed paved surface area ____ x $40.00

    C.) Total linear footage of disturbed grassed surface area ____ x $2.00

    Total Due by check or cash to the Village of Elm Grove prior to any work = A + B + C

  3. Post Submission Requirements

    A final inspection shall be coordinated with the Director of Public Works. All final work is subject to the approval of the Director of Public Works. Any outstanding balance related to the permitted work shall be paid in full to the Village at the time of final approval.

    If directional boring is a component of the proposed work to be performed, permittee shall televise any and all adjacent sanitary or storm sewers and provide copy to Public Works Director after work is completed.

  4. Acknowledgement

    By submitting this form, you agree to adhere to the rules and regulations set forth by the Elm Grove municipal code. Failure to adhere to the municipal code may result in penalties. You further acknowledge the Village Staff may need to enter onto your property to inspect the final project and have granted them permission to inspect the project during and after completion. 

  5. Office Use

    Post Submission:

    • Final Inspection Date
    • Outstanding Permit Fee Total
    • Director of Public Works Approval

    Permit Checklist

    • Complete Application
    • Copy of Corporate Surety Bond in the Amount of $2000.00
    • Check for the Fees - Payable to the Village of Elm Grove 
    • A Drawing Indicating the Approximate Location of the Work to be Done
    • Any Additional Items Needed by the Director of Public Works
    • Coordinate Final Inspection with the Director of Public Works
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