Application

URL
This field is for validation purposes and should be left unchanged.
Crossing Location * Required
- Within Greeley City Limits
- Outside Greeley City Limits
1. Contractor
Contractor * Required
Address * Required
Street Address Address Line 2 City State ZIP Code
Email * Required
Phone * Required

3. Proposed Facility
Estimated Construction Date
Month
Day
Year
PLSS * Required
(Section, Township, Range)
Address or Intersection of Construction
Description of Location:
Distance/Direction (__ft N S E W) from cross street, side of street, etc
Method of Installation * Required
Add a separate row for each crossing
Encasement Conduit * Required
Add a separate row for each crossing
Material Size Type
Facility to be Installed
Pipe Size KV Info Type (Telephone/Cable/Water,etc)

4. Crossing Information
Type of Crossing
- As-Built
- Pre-Approval
City of Greeley Facility
Add a separate row for each crossing
Water, Sewer, Non-Potable, Service Line, Transmission Line #, and/or Storm Water Line Pipe Size Pothole Depth (from surface grade to the top of pipe)
Crossing Information * Required
Add a separate row for each crossing
Over or Under COG Proposed Installation Depth (from surface grade to top of pipe) Reamer Size (if bore) Crossing Clearance (total separation of pipelines including reamer)
Easement Information
Add a separate row for each crossing
Width of COG Easement Reference Number

Crossing Approval Packet

Water, Sewer, Non-Potable, Service Line, Transmission Line #, and/or Storm Water Line	Pipe Size	Pothole Depth (from surface grade to the top of pipe)

Over or Under COG	Proposed Installation Depth (from surface grade to top of pipe)	Reamer Size (if bore)	Crossing Clearance (total separation of pipelines including reamer)

Material	Size	Type

Pipe Size	KV Info	Type (Telephone/Cable/Water,etc)

Width of COG Easement	Reference Number