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Utility Permit Work Form
Southeast Louisiana Flood Protection Authority – West
Utility Permit Work Form
Utility Name
*
Permit Number
*
Point of Contact's Name
*
Point of Contact's Email Address
*
Point of Contact's Phone Number
*
Work Location Address
*
City
*
State/Province
*
ZIP / Postal Code
*
Add Latitude and Longitude for the point of excavation closest to the Mississippi River levee or hurricane protection system. For additional points of excavation, press the "Additional Latitude - Longitude" button below.
Latitude
Longitude
Please provide a full description of the proposed work.
*
Excavation Dimensions (feet, inches) For additional excavations, please select the "Additional Excavation" button below.
Length
*
Width
*
Depth
*
Please provide the approximate nearest distance from the Mississippi River Levee centerline or hurricane protection system:
Distance in Feet
*
Please provide approximate Start and End dates for the permitted work.
Start Date
*
End Date
*
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