Jerusalem, NY · Yates County
Road Opening Permit Application
This application requests permission for a contractor to dig in or obstruct a road in the Town of Jerusalem.
What this form is
The Town of Jerusalem Road Opening Permit Application requests permission for a contractor to dig in or obstruct a named road. It asks for the property owner’s contact information, contractor and road details, and payment information; it also says a certificate of general liability insurance and Dig Safe certification must be filed or documented.
Who needs it
Property owners and contractors seeking permission to dig in or obstruct a road in the Town of Jerusalem should complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form lists a $35 application fee and a $1,000 deposit, with separate checks required.
About notarization
This document is signed and dated without a notary; the signer agrees to the permit conditions, and the form does not specify a notarized or sworn attachment.
How to submit this form
- 1
Download The Application
Download the Road Opening Permit Application.
- 2
Complete The Application
Print all entries and provide the requested property owner, contractor, road, payment, and certificate information.
- 3
Gather Required Items
File the contractor’s certificate of general liability insurance with the application and note the Dig Safe certification certificate file date.
- 4
Submit To The Town
Submit the application to the department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Road Opening Permit Application?
- No. The application has a contractor signature and date line but no notary block. The form also does not specify a notarized or sworn attachment.
- How do I submit the Road Opening Permit Application?
- Submit it to the city department named on the form; check the city website for current contact details. The form requires separate checks for the $35 application fee and $1,000 deposit.
- What documents must be filed with the application?
- The form says a contractor’s certificate of general liability insurance must be filed with the application. It also includes a field for the Dig Safe certification certificate file date.
Need something notarized?
This Road Opening Permit Application doesn’t need a notary — but if you have another Jerusalem form that does, a commissioned online notary can help.