Municipal Utility Locates Request Address or location of work:* Company name (If applicable): Name of contact:* First Last Phone*Email* Notice Given by: First Last Email* Phone*Excavation method:* Excavation depth (meters):* Description of work:*File Upload Drop files here or Select files Max. file size: 64 MB. Upload an image providing mark-ups on an aerial image of the proposed work area along with any additional description required to clarify the work area.Date locate requested:* Year Month Day Planned Start Date:* Year Month Day Terms & Conditions* I agree to the terms and conditions“Utility” means the Town of Niverville, its employees, or agents. By requesting this Locate, you acknowledge that you are the owner or the authorized agent of the owner of the work area(s) and you agree to the following terms and conditions: 1. Locates completed as a result of this form apply only to facilities owned by the Utility. 2. While completing the work, you shall comply with any instructions described in the completed Locate and will comply with all applicable statutes and regulations. 3. The Utility shall have no liability or responsibility whatsoever for the work including any Locate errors. You are solely responsible for any claims, costs, damages or loss, including property damage, personal injury or death, arising from, caused by or related to the work. You shall indemnify and save the Utility harmless from and against all manner of action, suit, debts, claims, costs, losses or demands, including claims by third parties, that arise as a result of the work. 4. Take every precaution to avoid damage or stress to the Utility’s facilities. Never move the facilities without prior consent and supervision by the Utility. When backfilling, ensure that any underground facilities owned by the Utility remain in place and that they do not settle or otherwise shift in position. Support and thoroughly tamp any backfill under the facilities. In the case of damaged infrastructure, do not backfill until the Utility has inspected the facilities and approved backfilling to occur. You shall reimburse the Utility for costs, loss or damage incurred by the Utility as result of the work. 5. You must obtain a new Locate if work does not commence within 14 days of the completed Locate. 6. This Locate applies only to the work area you have specified on your attached marked up aerial imagery. If the nature of the work or the work area changes or the marks become displaced or obscured, stop work and obtain a new Locate. 7. The information provided in this Locate and or as marked on site is an approximate location only. You must determine the exact location and depth of the facilities by soft digging at several locations before excavating with mechanical equipment. If the exposed facility location varies from the marked location, stop the work and contact the Utility immediately to confirm the location. If not already completed, contact the Town office at 204-388-4600 for a damage deposit form for work completed on public property. You must notify the Utility immediately of any damage or disturbance to a facility by contacting 204-388-4600 extension 211.