| Certificate of Completion and Five-Year Warranty |
Please fill out all applicable information below when site is restored. Reference Utility & ROW Accommodation Policy Section 96.911.
*NOTE: Submittal of this form constitutes a signature, confirms the accuracy of the data provided, and provides agreement to the terms in the disclaimer.
As the authorized representative of the above-listed company, I hereby certify that work has been completed and agree to accept the financial responsibility for the maintenance of the work done under this utility permit associated with the project on or along the above-mentioned county trunk highway for the period of five (5) years from the restoration/final acceptance date of the project.
*NOTE: Submittal of this form constitutes a signature, confirms the accuracy of the data provided, and provides agreement to the terms in the disclaimer.
In emergency situations, or if Kewaunee County notifies the above listed company or individual of a maintenance problem and it is not resolved in a timely manner, the Kewaunee County Highway Department will perform the maintenance on the project, and all costs would then be billed to the responsible party(ies).
*NOTE: Submittal of this form constitutes a signature, confirms the accuracy of the data provided, and provides agreement to the terms in the disclaimer.