Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Utility Contractor Registration

  1. As outlined in Miami County Resolution No. R 11-12-042, each person who occupies, uses, or seeks to occupy or use, the right-of-way or any facilities in the right-of-way, including lease, sublease or assignment, or who has or seeks to have, facilities located in any right-of-way shall register with the Miami County Utility Division.

    This registration application must be complete prior to the construction, installation, repair, relocation, removal or performance of any other work on, or use of any facilities or any part thereof in any right-of-way. Upon approval of this application and submittal of the per permit fee, a Certificate of Insurance and Performance Bond, registrant will be granted approval, per permit, to work on and in county rights-of-way.

  2. Please enter the company name of the contractor
  3. Utility relocation contractors must be registered with Kansas One-Call©
  4. If Primary Contact is not local to Miami County, Kansas, please provide alternate local contact for emergency purposes.
    By clicking "Submit" below, Permittee expressly acknowledges and agrees, by acceptance of the registration, to indemnify, defend, and hold harmless the County, its officers, boards, committees, commissions, elected officials, employees and agents, from and against all loss or expense (including liability costs and attorney’s fees) by reason or any claim or suite, or of liability impose by law upon the County or its agents or employees for damages caused because of bodily injury, including death at any time resulting therefrom, sustained by any person or persons or on account of damages to property, including loss of use thereof, arising from, in connection with, caused by or resulting from the Permittee’s acts or omissions in the exercise of its rights under this permit, whether caused by or contributed to by the County or its agents or employees.
  6. Leave This Blank:

  7. This field is not part of the form submission.