Highway Use Permit Form

Depending on the type of development, one may require a Highway Use Permit. Please complete the form below.

For a permit to temporarily put a bin or container on a city street, please fill out our Highway Use Permit Form - Container or Bin Placement form instead. For oversize loads, please see our Oversize Overload Permit.

Pursuant to Bylaw Section: 33.0

Bylaw No. 6704-2009

Please allow 5 to 10 business days for processing.

Date:

File No.	And
File No.	And

Name of Permittee

Company

This form allows you to save a draft. An email with a link to your draft will be sent to the address provided above upon the draft’s first save. Subsequent saves will not resend this email. Upon submission, you’ll receive a second email confirming the final values provided.

Phone

Address

Address 2

City/Town

Province/State

Postal Code/ZIP

Country

Name of Prime Contractor

Company

Phone

Address

Address 2

City/Town

Province/State

Postal Code/ZIP

Country

Principal Contact

Company

Phone

Fax Number

On-Site Contact is the same as the Principal Contact

On-Site Contact

Company

Phone

Fax Number

Pursuant to the Provisions of Maple Ridge Highway and Traffic Bylaw No. 6704-2009, Permission Is Hereby Granted to the Above-Named Permittee To:

Permit Dates and Times

Re-order	Start	End	Weight	Operations
	Start Start: Date Start: Time	End End: Date End: Time	Item weight

More Item(s)

Terms and Conditions

This permit shall be valid and subsisting from the start and end dates/times listed above and at all times during the currency thereof, shall be subject to cancellation if the holder thereof shall neglect, fail or refuse to observe and to comply with all the requirements of Maple Ridge Highway and Traffic Bylaw No. 6704-2009, and is issued subject to the following conditions:

That all necessary plans and specifications of any works involved have been deposited with the Permits Department and have been approved
That this Permit shall be valid only for the specific works or other uses of a Municipal Highway stated herein. All alterations and additions must be covered by a separate Permit
That the construction and maintenance of any works under this Permit shall be carried out and completed to the satisfaction of the City of Maple Ridge
That any person appointed by the City of Maple Ridge for that purpose shall have free access at all times to all parts of any works constructed under this Permit for the purpose of inspecting the same
That while reasonable care will be taken on the part of the City of Maple Ridge to avoid damage to any private works constructed under this Permit while carrying out the construction or maintenance of any public work in any highway, the City of Maple Ridge accepts no responsibility of any kind for such damage if the same should result from such public work
That the Permittee shall save harmless, defend and indemnify the City of Maple Ridge from and against all claims, damages and lien claims of every kind, arising out of or in any way connected with any works or other things for which this Permit is issued
That the Permittee, or his contractor if applicable, shall obtain and maintain during the term of this Permit a comprehensive general liability insurance policy providing coverage of not less than $5,000,000.00, naming the City of Maple Ridge as an additional named insured and providing that the said policy shall not be cancelled, lapsed or materially altered without 30 days notice in writing to the City of Maple Ridge. A copy of such policy shall be delivered to the City of Maple Ridge prior to the issue of this Permit. The permittee shall disclose the name of the prime contractor
That the Permittee shall replace and repair all municipal infrastructure effected by the work and such infrastructure is to be returned to an equal or better condition than that which existed prior to the work, all within 24 hours of the completed work, to the satisfaction of the City of Maple Ridge
That appropriate traffic control practices must be followed as per the Provincial Traffic Control Manual for Works on Roadway 2nd edition, and to the satisfaction of the City of Maple Ridge; That the Permittee must notify and abide by all requirements of all emergency services (Police/Fire/Ambulance)
That the Permittee shall at all times be responsible for the safety, adequacy, efficiency and sufficiency of his work, his plant, his equipment and his method of executing the work whether by himself or his sub-contractor. His work shall at all times be protected by adequate barricades, signs, flares, fences, lanterns, guards or other such means placed as required and maintained during the work to protect the public and avoid property damage
That the Permittee shall comply with the City of Maple Ridge Noise Bylaw No. 5122-1994 during the period of construction
That no mud, dirt, earth, soil or debris from the work site shall be permitted to be deposited on Municipal property
That the Permittee notify and abide by all requirements of other interest groups, including but not limited to Telus, BC Hydro, Greater Vancouver Regional District (GVRD), Ministry of Environment, Lands and Parks and the Ministry of Transportation
That the Permittee shall take extra precaution to ensure the safe passage of pedestrians on the sidewalk before, during and after the event
That the Permittee shall contact the Municipal Works Inspector to arrange the required inspections
That the Sidewalks and Curbs shall be reconstructed to Municipal standards

That the Permittee will deposit with the City of Maple Ridge a sum of $150.00 plus $7.50 GST (Highway Use Permit Fee) with a refundable security deposit based on the extent of the work in cash or cheque, to guarantee the fulfillment by me of the terms and conditions set out herein within the time specified in this permit.

If also applying for a Utility Permit, the following fees will be invoiced to the applicant:

Permitting Inspection Fee
Pavement Degradation Fee

I acknowledge I have read and understand the above, and will fulfill all requirements set out on this form to the best of my knowledge and abilties.

Sign above.

Upload Drawings

Description, drawings or pertinent information indicating the extent of work or activity within the road right-of-way.

Additional Requirement for Utility Permits (If Applicable):
Engineer-stamped drawing for construction within road right-of-way.

Upload Traffic Management Plan

Describing any traffic control measures that may be necessary to complete the work.

Upload Insurance Policy

Copy of $5,000,000 Liability Insurance Policy:

Must have the following statement written in the policy:
"Naming the City of Maple Ridge as an additional insured and providing that the said policy shall not be cancelled, lapsed or materially altered without 30 days notice in writing to the City." The policy shall also include a Cross Liability Clause.

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Personal information entered on this form is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA) for the purposes of processing your input. If you have any questions or concerns about how your information will be used, contact the FOI Office by calling 604-466-4300 or by emailing FOI@MapleRidge.ca. For more information about FOIPPA at the city, please visit our Freedom of Information page.