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Permits

Work Permit Application

Complete this form to apply for a RIOC Construction Work Permit. Only completed applications will be reviewed. Please allow 10 business days for review.

Reason for Filing

Reason for Filing *

Initial ApplicationRenewal (No Changes)Renewal (With Changes)

Last time worked on island

Work Schedule

Start Time

End Time

Expected Work Start Date *

Must be at least 10 business days from today

Expected Work End Date

Location Information

Building/Location Name *

Street Address *

Property Manager

Project Details

Job Description / Scope of Work *

Weather limited? *

Vehicles for planned work *

Parking spaces needed

Temporary road closure

Flagmen/traffic control

Applicant Information

Applicant Type

First Name *

Last Name *

Business Name

Business Telephone

Business Fax

Business Address

City

State

ZIP Code

Mobile Telephone *

Email *

Taxpayer ID

Sub-Contractors

Will sub-contractors be used?

Insurance

Certificate of Insurance

Upload your certificate of insurance document

Maps / Drawings / Safety Plan

Document A

Document B

Document C

Applicant Statement & Signature

I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. I agree to comply with all RIOC rules, regulations, and permit conditions. I understand that failure to comply may result in permit revocation and/or additional penalties.

Applicant Name *

Date *

Electronic Signature *

Please sign below using your mouse or touch screen.

Sign above

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