How do I submit the Highway Work Permit Application?

Return all four pages and the required certificate of insurance to the Director of Public Works at 79 Rexford Street, Norwich, New York 13815.

What attachments are required with the application?

Attach a map or sketch of the proposed work and its location, and a certificate of insurance listing Chenango County as additional insured.

Can I begin work after submitting the application?

No. The application says not to begin work until the permit is issued and the applicant complies with its conditions.

Chenango County, NY · Chenango County

No notary required

Highway Work Permit Application

Chenango County businesses and contractors use this application to request permission for highway work and provide details about the proposed activities and location.

At a glance

Issued by: City of Chenango County · Chenango County, Chenango County, New York
Notarization: Not required: file this form without a notary.
Official source: chenangocountyny.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

This application requests a Chenango County highway work permit for activities at a specified location. It asks for the applicant company's legal name, address, contact information, work details, and an attached map or sketch; applicants must also attach a certificate of insurance listing Chenango County as additional insured. The applicant agrees not to begin work until the permit is issued and its conditions are met.

Who needs it

A company seeking permission to perform work on a Chenango County highway must complete the application and accept the permit terms.

How to submit it

Return all four pages with a certificate of insurance listing Chenango County as additional insured to the Director of Public Works, 79 Rexford Street, Norwich, New York 13815.

About notarization

This application is signed and dated without a notary; attach a map or sketch and a certificate of insurance listing Chenango County as additional insured.

How to submit this form

1
Download the Application
Download the four-page Highway Work Permit Application.
2
Complete and Sign
Fill in the applicant company's information and describe the proposed activities and their precise location. Sign and date the application.
3
Gather Attachments
Attach a map or sketch of the proposed work and a certificate of insurance listing Chenango County as additional insured.
4
Submit to the County
Return all four pages and the certificate of insurance to the Director of Public Works at 79 Rexford Street, Norwich, New York 13815.

Frequently asked questions

Do I need a notary for the Highway Work Permit Application?: No. The application is signed and dated without a notary. Attach a map or sketch and a certificate of insurance listing Chenango County as additional insured.
How do I submit the Highway Work Permit Application?: Return all four pages and the required certificate of insurance to the Director of Public Works at 79 Rexford Street, Norwich, New York 13815.
What attachments are required with the application?: Attach a map or sketch of the proposed work and its location, and a certificate of insurance listing Chenango County as additional insured.
Can I begin work after submitting the application?: No. The application says not to begin work until the permit is issued and the applicant complies with its conditions.

Need something notarized?

This Highway Work Permit Application doesn’t need a notary, but if you have another Chenango County form that does, a commissioned online notary can help.