Type Full Name :
Sign With Hand
Excavation / Opening Information
City
2 Year Cash Repair Deposit
Is the opening within 200 feet of a gas pipeline?
ZIP
Proposed Date of Completed Restoration *
Proposed Completion Date *
2. $50,000 Performance Bond on record for Contractor
($500 for opening under 20 square feet. $25 per square foot for openings over 20 square feet.
The documents below are required. You can attach them to this application by clicking the Select Files... button.
Contact Person Name *
Borough of
Atlantic Highlands
Email
City
Address or Location
Contractor Information
Phone #
Fee Schedule
Email *
State
Required Attachments
Phone # *
Last Name *
Last Name
Property Owner Information
Purpose of Work *
Dig / Mark Out #
Address
Applicant Information
ZIP
State
1. Certificate of Insurance / Hold Harmless ($300,000 - One Person / $1,000,000 One incident / $500,000 Property)
Street Opening / Curb /
Sidewalk Application
Proposed Start Date *
Email
City *
First Name *
Applicant Signature *
ZIP *
Application Fee - Payable to Borough of Atlantic Highlands.
State
Address
Checklist
Certification
First Name
Phone #
Have you called NJ One Cal? 1-800-272-1000
Address *
100 First Avenue, Atlantic Highlands, NJ 07716
Phone #: (732) 291-1222 | Fax: (732) 291-9725
www.ahnj.com
Will this require additional Traffic Control measures?
Size of Opening (Sq ft)
Company Name *