Term Extension of Right of Way Permit

2. Original Right of Way Permit Number*

4. Applicant First and Last Name*

6. Applicant Phone Number*

8. Applicant Email*

10. Reason For Permit Extension*

12. New Date for Completion of Project (Can Not Exceed 60 Days)*

14. Changes or Additions to Original Project Causing Additional Time Need for Completion*

16. Fees
    Link to make payment

    A fee of $100 for each extension period is required.

Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field