West Jordan City Engineering Department
Example: Public Right-of-Way Encroachment Permit Application & Agreement
Permittee Information
Contractor / Work Information
1. Standards / Location of Work
The above indicated Contractor, (hereinafter referred to as “Permittee”) is hereby granted subject to Title 8, Chapter 8 of the West Jordan City’s Municipal Code, City’s Policies and Design Criteria Manuals, Construction Specifications Manual, Standard Drawings Manual, State Occupational Safety and Health Laws, Manual on Uniform Traffic Control Devices (MUTCD), Instructions to Flaggers, the approved plans, and any special limitations set herein, permissions for the purpose of install underground fiber conduit and associated utility facilities within the right-of-way limits at the following location(s): 7800 South between 4000 West and 4200 West.
2. Prior to Work
Prior to work being performed in the public right-of-way, the Permittee will make proper provisions for protecting the public safety and property. This permit is a binding agreement between the Permittee and West Jordan City and shall be only for the location as listed above.
For any excavation in the public right-of-way, as listed on the Current Uniform Schedule of Fees and Services charges will be calculated upon approval of permit – REQUIRED.
Work Area Dimensions
The work permitted here within shall commence on 05/15/2026 and shall be diligently prosecuted to completion on or before 06/15/2026.
Required Application Documents
- Application must be signed and dated by the authorized party.
- Attach Certified Traffic Control Plan.
- Bore Profile for all roadway crossings — STAMPED BY A CERTIFIED ENGINEER.
- Site map with the following information included:
Performance Bond
The Permittee shall provide to West Jordan City a performance bond for a three (3) year period prior to approval or completion of the work to guarantee satisfactory performance. The three (3) year period is required to be stated on the bond.
3. Notice of Work to Begin
Before work permitted herewith is commenced, the Permittee shall notify wjrow@westjordan.utah.gov at least 24 hours before work begins.
The following information is required in the email:
- West Jordan City Permit Number (located at the top of the approved permit)
- Location of work
- Confirmed Start Date
- Confirmed Completion Date
If emergency services, school, districts, UDOT, UTA, road closures or detours apply to the permit is required two (2) working days in advance. Additional approval maybe required through West Jordan City Administration (the City Administrator’s Offices.)
Residence required to be notified 5 day prior to work beginning.
Commencement of said work is understood to indicate that the Permittee will comply with all instructions and regulations of West Jordan City with respect to performance of said work and that the Permittee will properly control and warn the public of said work to prevent accidents.
4. Notice of Work Completion
After work completion herewith approved permit has been completed, the Permittee shall notify wjrow@westjordan.utah.gov for a Work Completion Inspection, walk through/punch list if more than 5 items project incomplete and not ready for inspection.
The following information is required in the email:
- West Jordan City Permit Number (located at the top of the approved permit)
- Location of work
- Confirmed Completion Date
Prior to notice of permit completion, Permittee agrees the following has been completed:
Fill out each checkmark below once completed
- Concrete Tests
- Compaction Tests
- Asphalt Tests
- Backfills
- Gradation and Compaction
- As Built Drawings (if required)
A final completion inspection will be completed for approval, with the final approval of completion from the Engineering Inspector the permit will be closed out.
A final inspection will be completed within 48 hours of work completion notification.
If additional time is required for permit, the Permittee shall notify wjrow@westjordan.utah.gov, additional fees may apply with the approval of the extension.
The following information is required for an extension request:
- West Jordan City Permit Number (located at the top of the approved permit)
- Location of work
- Reason for requested extension
- Requested completion date
If the Permittee fails to meet or notify of completion within the time indicated herein, West Jordan City will apply an extension fee and additional fees will be assessed.
Permit has not been closed out until a final inspection has been completed and the work has been accepted by the Engineering Inspector.
5. Limits of Work Area
Permittee shall not perform any work in West Jordan City’s right-of way beyond those areas of operation stipulated on this permit.
This permit is no way allowing the Permitee to access private properties: the individual property owners must grant Permitee access with required documentation
6. Suspension of Work
If Permittee fails to comply with West Jordan City’s regulations, specifications, or instructions pertinent to this permit, the City Engineer or duly authorized representative, may give a verbal order to suspend the work until the violation is corrected.
If Permittee fails or refuses to comply promptly, the City Engineer or duly authorized representative may issue a written stop work order on all or any part of the work, until corrective action has been taken and approval has been given by the City Engineer or duly authorized representative.
7. On-Site Permit Requirements
Permittee is required to provide all approved plans and documents of permits on site at all times. The Inspector shall be granted access to the approved permit at all times.
8. Temporary Asphalt Patching
Asphalt patching to roads between October 15 and March 1 will be considered temporary only and must be replaced after March 1 following APWA standards.
9. Special Limitations
- All road closures require upper management approval.
- Permittee is required to call for Blue Stakes and check for existing utilities in the area prior to excavation (bore profiles)
- Saw cuts and tack coat joints, replacement of asphalt to the existing depth plus 1-inch, with a minimum of 4-inches, or as directed by West Jordan City Engineer
- Untreated base course with 97% compaction for the full trench depth with 6-inch lifts.
- Permitee is responsible for repairing and or restoring any portion of the roadway damaged during construction
- Permitee is responsible to restore shoulder to it’s original or better conditions to include: reseeding, replacing sidewalk, fencing, pipe, culverts, or signs removed or damaged during construction
- Striping is to be replaced with the same material within 48-hours of completion of the asphalt patch. The materials must maintain West Jordan City standard specifications for 6-months
- No storage or backfill material or pipe will be allowed within the ASHTO Clear Zone. Excavations to be backfilled daily if possible
- Permittee must comply with all applicable environmental SWPPP laws.
- Steel drum vehicles or steel tracked vehicles or equipment shall use minimum 3/4 inch plywood over railroad concrete pavement to protect the concrete while crossing the railroad track area
- Concrete paved roadways, the permittee is responsible for all panels that have 2-inch holes bored into the panel. IF these panels fail in the future due to the bores, the Permitee will be required to replace the affected panels
Acceptance by Permittee
I, as the permittee, understand that a permit is required for encroachment into any West Jordan City right-of-way, West Jordan easement, or West Jordan utility system, including but not limited to construction, maintenance, and obstruction to vehicle and pedestrian traffic. My execution of the activities allowed by this permit is conclusive evidence that I have accepted all provisions, limitations, restrictions, and attachments of this permit and agreement. I understand and agree to all penalties of failing to comply with this permit and agreement.
