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ORF Home > Standards, Policies & Guidelines > Temporary Construction > Appendix A Request for use/closure form

Appendix A Request for use/closure form

Request for Temporary Use / Closing of Roads / Parking / Sidewalks or Other Paved Area

Location (Describe and note on attached map):


Dates and Time of Usage Requested:


Extent of Usage (road width, no. of lanes, etc.):


Controls to be Provided (barricades, flagmen, etc.)


Requested By: __________________________ ______________
                                                 Project Officer                          Date

 __________________________________________________________________  

Approved By: _____________________________ _______________ 
                        Grounds Maintenance                                        Date
                        and Landscaping Section, ORF

          ___________________________ _______________
          Fire and Emergency Response                  Date
          Section (NIH Fire Dept.), DPS           

           ___________________________ _______________ 
           Police Branch, DPS                                      Date

Comments or Conditions Imposed by Approving Officials: 

 ________________________________________________________  

________________________________________________________  

________________________________________________________

 

 

 


 
This page was last updated on May 23, 2013