Permit Request • CampusOptics

Elevated Work Permits must be completed whenever work will be performed from an aerial lift. Must have a qualified coworker who can assist in rescuing the elevated worker should the need arise.

Requester Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Permit Date & Time

Start Date* Required

Start Time* Required

Expiration Date* Required

Expiration Time* Required

Location

Name* Required

Additional Location Details

PERMIT

Authorized Operator* Required

Authorized Operator Phone* Required

Authorized Spotter* Required

Authorized Spotter Phone* Required

METHOD FOR FALL PROTECTION

Fall Protection Required* Required

Is this work Authorized* Required

Emergency * Required

Add Supporting Documents

Add files to upload as supporting documentation along with your permit request.