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H:\Airport Development\SHUTDOWNS-HWP - CIA\Forms\2013 Forms\Word Format 2013\External Services Shutdown 2013.docx For Office Use Only Permit # EXTERNAL SERVICES SHUTDOWN REQUEST Date: Send Request To: Project Name: Original Request: Revised Request: Planning & Engineering Email: [email protected] Project Number: Calgary Airport Authority Contact: CIP Number: Company Requesting Shutdown: Name: Email: Phone: Cell: Sub-trade Performing Work: Name: Phone: Cell: Scope of Work to be Completed: Is work Airside Yes No Is work is being conducted within the jurisdiction of: City of Calgary MD of Rockyview Has the City of Calgary/Municipality been notified? Yes No System Shutdown Requested: Domestic Water Supply Electrical Distribution Sanitary Sewer System Telecommunications Storm Water Collection System Shaw Cable Airfield Electrical Lighting PLH Fuel Lines Roadway Work – pedestrian, vehicle ATCO Gas Line Other (Describe) Security Escort Required: Yes No If yes, submit Security Escort Form (see YYC.com) Request Submitted Requested Date of Shutdown: Maximum 1 week Start: End: Requested Time of Shutdown: 24 hour clock MUST be used Start Time: End Time:
