Any work performed within the right-of-way of a township road requires submission of three (3) copies of this form along with three (3) copies of a sketch showing the location and details of the proposed work.
Any work performed on a township road over, under, or within the limits of a limited-access state highway requires a state permit. The prescribed permit fee shall accompany the application and sketch. Schedules of fees and furnished on request. The fee(s) shall be paid by check(s) or money order(s) and shall be payable to the township affected.
*check payable to the Township of Derry can be payable to “Derry Township.”
Road Occupancy Permit Application (PDF)
Download the Road Occupancy Permit Application form
