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TOWN OF WOODBURY
1672 VT RT 14
P.O. BOX 10
WOODBURY, VERMONT 05681
E-mail: clerk@woodburyvt.org�
Phone: 802-456-7051
Web Site woodburyvt.org
Town of Woodbury Request for Bid
�7�K�U�H�H�Year Contract for Winter Sand
The Town of Woodbury is soliciting bids for 3,000 cubic yards of Winter Sand
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The sand shall contain 3/8”to 1/2” stone minus screened sand and meet or exceed State
and American Association of State Highway and Transportation Officials (AASHTO)
specifications. (Please see the attached specifications sheet on page 3.) The Town may
request a sand sample to facilitate the bid award process.
The bid should specify two prices: a price if delivered by the vendor to the Town Highway
Garage at 524 Dog Pond Road, Woodbury and a price if picked up at the pit. Please include
the applicable discount percentage if a total annual invoice is prepaid.
Additional information may be obtained by contacting our Road Commissioner, Peter Dailey
at garage@woodburyvt.org or by calling 802.456.8883. Bid forms and bidding instructions
are available by contacting the Town Office by phone, 802.456.7051, or by emailing
clerk@woodburyvt.org or on the town web site woodburyvt.org at
Records/Requests for Proposals.

Bidders must have proper liability insurance in the minimum amount of $1,000,000.
Certificates of Insurance with the Town listed as certificate holder should be forwarded with
the bid.
Bids shall be in a sealed envelope, clearly marked “Bid for Winter Sand” and delivered to the
Town Office by noon on July 13, 2026. Bids will be opened at the Select Board meeting of July
13, 2026. The Town reserves the right to reject any or all bids, and to grant the bid that is
deemed to be in the best interest of the Town.
All bids must in submitted either in person or by mail as specified in the header. No faxed or
emailed bids can be accepted.
INSURANCE:
Worker’s Compensation: The successful bidder will carry Worker’s
Compensation insurance in accordance with the Laws of the State of Vermont.
General Liability: The successful bidder will carry General Liability Insurance
including but not limited to:
Premises
Products and Completed Operations
Personal Liability
Contractual Liability
Personal Injury Liability
The policy shall be on an occurrence form and limits shall not be less
than:
$1,000,000 Per Occurrence
$1,000,000 General Aggregate
$1,000,000 Products/Completed Operations Aggregate
$ 50,000 Fire/ Legal/Liability
Automotive Liability: The Party shall carry automotive liability insurance�covering
all motorized vehicles, including hired and non-owned coverage, used in connection with
the project. Limits of coverage shall not be less than: $1,000,000 combined single limit.
/s/ Chris Casey, Town of Woodbury Select Board Chair
(Duly Authorized Representative of the Town of Woodbury)

Specifications for Winter Sand
Winter Sand shall be clean, hard, screened sand, uniformly graded from coarse to fine, and
shall be reasonably free from silt, loam, clay, or organic matter. The sand shall be obtained
from approved sources and shall meet or exceed the following requirements, including passing
a Ph. test.
Sieve Designation % by Weight Passing Square Mesh Sieves
Up 1/2” 100
No. 4 90-100
No. 100 2-10
1. The material will be sampled by the Highway Road Crew and tested. 2. Product Availability:
Delivery Option: August-December
Picked up at the Pit: August-December
The Town reserves the right to contract with a third-party hauler to haul the product to
the Town site.
3. The Town reserves the right to test the product at any time and take appropriate
action if the product is deemed deficient including cancelation of the contract or
refusal of any delivery.
4. The successful bidder shall indemnify and hold harmless the Town, its officials,
agents, and employees from any loss or liability which may result from claims of
injury to persons or property from any cause arising out of or during the delivery of
product to the Town.
5. The Town reserves the right to purchase any product from any vendor other than the
accepted bidder.

Town of Woodbury
Town Office Building
1672 Vermont Route 14, P.O. Box 10
Woodbury Vermont 05681
Winter Sand Bid 3,000 Cubic Yards
Bids are to be submitted in a sealed envelope, clearly marked “Bid for Winter Sand” and
delivered in person or by U.S. Mail. No faxes or emails will be accepted.
Bids are due no later than 12 P.M. - Noon on July 13, 2026
Name of Bidder:
Bidder’s Address:
Bidder’s Email Address:
Bidder’s Phone Number:
Bid Amount Delivered: per Cubic Yard Delivered
Bid Amount at the Pit: per Cubic Yard at the Pit
Applicable Discount Percentage: %
Signature of Bidder:
Town of Woodbury
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Town Office Building
1672 Vermont Route 14, P.O. Box 10
Woodbury Vermont 05681
Winter Sand Bid 3,000 Cubic Yards
The Town of Woodbury is soliciting bids for 3,000 total cubic yards of sand per year for the
2026-202� winter season�V� The bid document is available at the Woodbury Town Office, 1672
VT Route 14, Woodbury, VT from 9:00am-1:00pm and on the town’s website, woodburyvt.org
under “Records/Request for Proposals.”
Bids are to be submitted in a sealed envelope, clearly marked “Bid for Winter Sand” and
delivered in person or by U.S. Mail. No faxes or emails will be accepted.
For any questions, please contact Graham Christie at clerk@woodburyvt.org or call
802-456- 7051.
Bids are due no later than 12 P.M. - Noon on July 13, 2026
Bids will be opened at the Woodbury Library Community Room on 7/13/2026 during
the Woodbury Town Select Board Meeting at 6:00pm

MEMORANDUM
Parties’ Request for Stay of Hearing
State of Vermont Land Use Review Board
District 5 Environmental Commission
10 Baldwin Street Montpelier, VT 05633-3201
https://act250 .vermont.gov/


DATE: June 22, 2026
TO: Applicant and Statutory Parties
FROM: Susan Baird, District Coordinator
District 5 Environmental Commission
RE: Application 5W0838- 6, Swenson Granite Company, LLC, Woodbury
Parties’ Joint Request for Temporary Stay of Hearing
https://anrweb.vt.gov/ANR/Act250/Details.aspx?Num=5W0838- 6
The District 5 Environmental Commission circulated a notice and draft proposed Land Use
Permit for the above- referenced application on February 20, 2026. The notice set March 17,
2026, as the deadline to file any comments.
On March 17, 2026, the T own of Woodbury filed a timely hearing request raising issues under
Criteria 5 and 7 regarding the Parties’ failure to establish an appropriate fee to be paid by the
Applicant to cover the impacts to town roadways from the proposed expansion of its quarry
operations.
On May 14, 2026, the Commission issued a hearing notice, setting June 2 6, 2026, as the date
for the hearing in the Woodbury Town Hall. The notice required the submittal of pre-filed
testimony from both Parties. The Town filed the required submittals on June 3, 2026. The
Applicant’s filing date was June 18, 2026.
On June 17, 2026, the Parties filed a joint Stipulated Motion to Stay the Proceedings for 60
days, during which time the Parties will engage in good- faith negotiation respecting a mutually
acceptable fee agreement. By the close of the 60-day stay period, the parties will update the
District Commission and either (i) file a stipulation with the District Commission resolving the fee issue, (ii) seek additional time for further discussions; or (iii) request the setting of a new
deadline for Swenson’s prefiled testimony and a new hearing date.
The Commission hereby grants the Motion, consistent with the provisions of 10 V.S.A, 6085(e)
which promotes the expeditious, informal, and non -adversarial resolution of issues, require the
timely exchange of information concerning the application, and encourage participants to settle
differences.
Accordingly, the public hearing scheduled for June 26, 2026, is hereby stayed for 60 days. The
parties shall update the Commission regarding the status of the negotiations on or before
August 21, 2026.

TOWN OF WOODBURY
1672 VT RT 14
P.O. BOX 10
WOODBURY, VERMONT 05681

Town Clerk: clerk@woodburyvt.org
Treasurer: treasurer@woodburyvt.org
Phone: 802-456-7051
FAX: 802-456-8834
Web Site www.woodburyvt.org

WOODBURY ZONING BOARD OF ADJUSTMENT
Date: June 17, 2026
Re: Swenson Granite Company, LLC, Michael Sylvester
Application: September 9, 2025 – Amendment to Non-Conforming Use Approval
Summary:
On September 9, 2025, an application was submitted by the above landowners, requesting
amendments to the previously existing approval for Non-Conforming Use. On September 11,
2025, the application was referred by the Zoning Administrator, Robert Martin, to the Zoning
Board of Adjustment for review as a change to the Non-Conforming Use Permit.
On October 27, 2025 a Notice of Hearing was issued, setting a hearing date of November 18,
2025. The hearing was held in recess to allow for additional fact finding.
On January 23, 2026 a Notice of Hearing was issued, setting a continuation of the recessed
hearing for February 12, 2026. The hearing was held in recess to allow for responses from the
applicant posed by the ZBA.
On June 15, 2026 a Notice of Hearing was issued, setting a continuation of the recessed hearing
for June 17, 2026.
Finding of Fact:
Due to the complexity of the application, the findings are impractical to list completely here. The
conclusions reached by the board were based on information gathered from the following
sources:
1. Application materials (on file at Woodbury Town Offices)
2. Two letters from Swenson Representative, Civil Engineer, Colen Johnson, Bowman (on file
at Woodbury Town Offices)
3. Information gathered at the two hearings. Recordings found here:
a. 11/8/25: https://www.youtube.com/watch?v=yqs1UdrIKiI
b. 2/12/26: https://hctv.us/woodbury-public-hearing-february-12-2026/

While there were several significant issues raised in the hearings the ones that came up the most
were:
1. Effects of increased traffic, including; road wear and tear, dust, safety for other non-
quarry vehicles and for the school.
2. Environmental effects, including; loss of natural beauty, pollution, excessive noise
3. Unforeseen, long-term impacts on the town associated with approving a permit change
for 60+ years.
The Board reviewed the application with the general standards of the Zoning Ordinance, Section
2.11 “Non-Conforming Uses…”. Regarding the proposed use, the Board must find that “…no
greater detrimental effect on the community will result.”
Conclusions:
Woodbury Zoning Board of Adjustment (ZBA) met on June 17, 2026 at 5:30pm. The board voted
unanimously to approve, with the following conditions, Swenson Granite Company’s application
dated September 9, 2025 to amend the previously approved non-conforming use granted to
Swenson Granite Company, LLC. the operator of the granite quarry, located at 1127 Cabot Rd,
Woodbury, VT.
The ZBA would like to note that the conditions below are informed by input from both the
community and representatives from Swenson. The one condition that stands out as diverging
from previous discussions is Condition #6. Swenson’s has stated that 40 trucks per day will be
required to make the crushing operation viable. The ZBA is approving a lower number based on
testimony from Swenson that it is not currently operating at capacity. This will allow time for the
community to get used to the larger truck volume and for Swenson to demonstrate the ability to
operate the increased volume without need for additional conditions regarding traffic impacts. If
business conditions become such that increased trucking capacity is needed, Swenson can apply
to the ZBA for an amendment to these conditions. The ZBA is committed to supporting Swenson’s
ability to successfully run a business while positively cohabitating with the Woodbury community.
Non-Conforming Use Amendment Approval Conditions:
1. Maintain the current regulatory and traffic restriction for trucks traveling to and from the
quarry. Including no trucks leaving between 7:15am-8:00am and 2:45pm-3:30pm during
the school year.
2. All dump trucks shall be covered prior to leaving the site.
3. No more than two loaded trucks shall exit the site simultaneously (within 5 minutes)
to avoid convoying.
4. Year-round, all haul dump trucks (gravel trucks) shall only enter and exit the property via
the original Swenson Quarry Road entrance which is closer to town. Not the new
entrance, which is farther from town.
5. During winter months, all haul trucks (including flatbed trucks) shall only enter and
exit the site via the original Swenson Quarry Road entrance which is closer to town. Not
the new entrance, which is farther from town.

6. The maximum number of truckloads per day shall not exceed 32 truckloads (combined
haul trucks – gravel and block).
7. Swenson will be responsible for sound monitoring for a minimum of 5 days when the
crusher is running in its first year. Results of the monitoring must be submitted to the
Town Clerk no more than 60 days after completion of the first day of monitoring and
successively for each additional day of monitoring.
8. Sound monitoring will occur as outlined above any time a different type or model of
crusher is used.
9. The expansion and proposed crushing will not impact environmental natural resources,
and Swenson will implement the stormwater improvements as shown in the application
materials.
10. Swenson remains committed to ensuring that no disruptions to the Town emergency
communications services occur. As such, Swenson will work with the Town to relocate the
services to another portion of the property prior to the tower being removed in the
future.
11. Swenson will follow the Phase timing outlined below. If adjustments need to be made due
to site or business conditions, Swenson will apply to the ZBA for an amendment to the
permit conditions. The phases below correspond to the Phase called out in the application
documentation submitted to the ZBA.
a. Approximate Lifespan at Full Production
i. Phase 1 ~ 2-8 years (Ending 2028 – 2034)
ii. Phase 2 ~ 6-14 years
iii. Phase 3 ~ 9-19 years
iv. Phase 4 ~ 5-11 years

The approval of the application is based on the plan outlined by Swenson in their application and
hearing response materials. These materials will be kept at the Woodbury Town Offices for future
reference. If there is a conflict between something in the application materials and the conditions
in this decision, the decision takes precedence.
Any failure to comply with the conditions set forth in this decision, will result in the termination
of approval of the entire Non-Compliance Amendment.
This Amendment is approved for a term of 8 years. After which time Swenson will need to return
to the Woodbury Zoning Board of Adjustment for ongoing approval.


Woodbury Board of Adjustment
By: __________________________ Jonah Meacham, Chair Date_________________
In concurrence: Skip Marchesani, Rick Cannon and Becky Browning

Forum to consider local democracy, June 22
GREENSBORO – The Hardwick Gazette is sponsoring a public forum “Strengthening Local
Democracy: Exploring ‘Both/And’ Ideas” at Highland Center for the Arts, Monday, June 22, 5
p.m., to consider questions about ways to strengthen local democracy.
With support from the Hardwick Equity Committee and Greensboro residents, the forum will be
led by Susan Clark, author of several books examining local democracy, including “Slow
Democracy” and “All Those in Favor,” a book about Vermont town meetings.
Greensboro has a special town meeting scheduled for June 30 to consider moving all Town
Meeting Day voting to Australian balloting,
Hardwick held a special town meeting May 19 to consider the same question and deferred the
decision while the select board appoints a task force to study the issue.
Craftsbury recently worked with Clark as they considered moving a portion of town meeting day
votes to Australian balloting, and explored a number of options to strengthen democracy
throughout the year..
This forum will feature both informative content and opportunities for conversation. It will be an
opportunity to pause, consider the values each of us brings to this discussion and investigate
democratic innovations emerging from communities across New England.
Clark has worked with towns throughout the region by helping them explore ways to improve
both democratic access and local engagement, valuing both the breadth and depth of
community decision-making.
Free dinner and free child care will be provided.
The event will begin at 5 p.m. with snacks before Susan Clark’s presentation on community
values around strengthening local democracy, traditional town meetings and Australian balloting
to make town decisions.
There will be a break for a light meal with more ideas to consider, followed by a presentation by
Clark about what is being tried in Vermont with some time for comments, thoughts and
discussion
The forum will adjourn at 8 p.m.
For more information contact editor@HardwickGazette.org. Those needing child care should
email editor@hardwickgazette.org with “June 22 Childcare” as the subject.

Contact: Paul Fixx, editor, The Hardwick Gazette, editor@hardwickgazette.org 802-535-4753

NOTICE AND AGENDA
Woodbury Select Board – Special Meeting
Monday June 15, 2026, 6:00 P.M.
at the Woodbury Town Office


6:00 P.M. Call the regular meeting to order

6:05 P.M. Convene an Executive Session pursuant to 1 V.S.A. § 313(a)(1)(E) –
Invite John Reid, David Mears

6:40 P.M. Close Executive Session. Report on any decisions made during the
session

6:45 P.M. Other business, if any

6:50 P.M. Adjourn

NOTICE AND AGENDA
Woodbury Select Board
Tuesday, June 9, 2026, 6:00 P.M.
Community Room at the Woodbury Library
NOTE CHANGE FROM REGULAR MONDAY MEETING DAY

6:00 P.M. Call the regular meeting to order
Adjustments to the Agenda
Approve Minutes from the May 27 meeting
Public Comment (for items not on the agenda)

6:15 P.M. Road Report – Peter Dailey and Michael Gray
West Woodbury Road update – sign permit
Scribner Road, update – sign permit
Grant projects updates – Michael
Garage Roof – any updates
The Ford 550

6:30 P.M. Town Treasurer’s Report – Lilly Baron

6:45 P.M. Update on Buyouts –- John Gordon

6:55 P.M. School Generator – who is in charge?

7:05 P.M. FEMA status update

7:20 P.M. Updates and Other Business
Appointments – Woodbury Fund Board
Approve Bills and Payroll Orders

8:00 P.M. Adjourn

Seeking Highway Maintenance Worker

The Town of Woodbury is accepting applications for a Highway Maintenance Worker
to join our Road Crew. This is a full-time position that requires a CDL (min Class “B”)
and the ability to work outside of regular working hours as necessary. Work takes
place outdoors, in the equipment, or in the shop. The ideal candidate will have at
least one year of experience in highway maintenance, including operation and
maintenance of highway equipment.
The starting hourly wage ($ 25-27) will depend on experience and qualifications.
Woodbury offers excellent benefits, including health and dental insurance, paid time
off, and an optional retirement plan. Candidates must be able to pass a physical as
well as a drug test.
Contact the Town Office for a job application and job description (clerk@woodburyvt.org) or
802-456-7051 to receive a paper copy in the mail, or stop at the Town Office at 1672 VT RT 14
in Woodbury. A job description and application can also be found on the Town web site
www.woodburyvt.org.
The position will be open until filled.

Job Description and Application follow on the next pages.

TOWN of WOODBURY
Highway Maintenance Worker Job Description
Summary of Duties and Responsibilities:
A Highway Maintenance Worker for the Town of Woodbury is primarily responsible for the
maintenance and repair of the Town Highway system and associated equipment. Under the direction
of the Road Foreman, or Select Board, crew members operate the equipment and provide the labor
to facilitate highway grading, trucking, snow plowing and sanding highways, brush clearing, road
repair, light building and facility maintenance, and other associated tasks as required.
Specific Duties and Responsibilities:
-Safely operate Town highway maintenance equipment, including but not limited to: pickup trucks,
dump trucks, bucket loader, road grader, backhoe, tractors with and without various attachments
including mowers and wood chippers. and other equipment required for the maintenance of the
highways.
-Safely operate various hand machinery such as chain saws, weed or brush trimmers, mowers and
welders. In addition. uses shovels. picks. rakes and other hand operated equipment necessary for
highway maintenance.
-During the winter months, the duties chiefly require snow plowing, snow removal, road sanding,
salting, and patching. Applicants must be available for considerable overtime during heavy snowfall
or other emergencies and be able to work in extreme weather conditions.
-Applicants may be required to report for duty outside of their regular work schedule and be
reachable by phone or pager supplied by the Town of Woodbury. Applicants must be able to arrive
at the Woodbury Town Garage within thirty (30) minutes after a call-in.
-During Spring, Summer, and Fall duties include repair of gravel as well as asphalt roads, culvert
installation. hauling of materials and supplies, hauling or moving equipment, cleaning ditches and
culverts, installing road signs, cutting brush, mowing, and other tasks associated with the
maintenance and repair of the Town highways. The duties include major repair. rebuilding,
construction, grading and re-grading of gravel roads. repair and patching of asphalt roads.
-Road crew members are responsible for the general maintenance of the Town Highway
Department equipment. Both preventative and corrective maintenance tasks and adjustments are a
routine responsibility throughout the year. The crew members will keep daily records of hours,
locations of work. equipment and materials used, gas, diesel fuel, and oil. This information will be
entered daily on written time sheets and/or on computer time sheets.
Reports To: The Road Foreman
Receives specific instructions from the road foreman. who is responsible for carrying out Tov

stablished policies and procedures. The employee is responsible to receive these inst ructions. and
accomplish the task assigned in a safe. timely, and cost efficient manner.
SkiJl requirements:
-Knowledge and ability to operate the Town Highway equipment.
-Knowledge of the principles. practices, and techniques associated with the maintenance and repair
of gravel and surfaced highways.
-Skill in handling controls for starting, stopping, driving. and backing the Town vehicles. skill in
judging overhead and side clearances. turning radii, braking distances. and backing clearance.
-Knowledge and application of the techniques and practice for safe heavy equipment operation
including safe lifting heights. loading and load securing techniques, and dumping safety.
-Knowledge and application of safety rules and regulations for the movement of heav) equipment
are of paramount importance to this position. Applications of these rules are required at all times, on
the public way. and in remote situations.
-The initiative and mechanical ability to accomplish minor repairs . adjustments. and other
maintenance tasks on Tovn vehicles and equipment.
This position requires skill in communication and interpersonal relations to:
-understand and follow oral and written instructions
-keep records and possess basic skills to operate computers and use spreadsheets (training in the use
of Microsoft Word and Excel will be provided if needed)
-cooperate effectively with fellow workers and the Select Board
-exemplary conduct when interfacing with the public is an absolute necessity in this position.
The normal physical requirements including the ability and dexterity to reach. bend. turn. move
hands, move arms. move feet. and move legs to operate the hand and foot controls of standard and
maintenance vehicles are required. Normal, or correctable to normal, vision and hearing is required
for the safe operation of equipment. The strength and endurance to repeatedly lift heavy objects, pull
and tug objects. dig, chop and use other hand tools, and perform other strenuous activities is
required. The strength and endurance to perform effectively over long how-sand in adverse weather
conditions is required.
Maintaining a current and valid Vermont Commercial Driver's License (CDL) Class Bis reguired.
Education:
High School Diploma. GED. or similar equivalent education is required.
Terms of Employment:
The position is a full-time position. Overtime is required, especially during adverse winter weather

conditions, as necessary to keep the Town highways useable.
All new employees will be required to complete a six-month probationary period. Applicants must
satisfactorily demonstrate knowledge of road maintenance and repair work and possess a
Commercial
Driver's License (CDL), Class B, to successfully complete this probationary period.
Experience:
This position description includes two levels of experience and responsibility. Except as modified
below, all requirements of the above description apply to all levels of assignment.
Level 1: Level 1 is the entry level to this position. The physical ability requirements apply. The
employee may not have all the experience or knowledge in highway maintenance or heavy
equipment operation required. The employee must have the ability and interest to learn through
classroom and/or on the job experience to acquire the knowledge of techniques and practice
required. At this level, the employee is more dependent upon supervision and assistance from others
in the accomplishment of the assignments.
Level 2: Level 2 includes all of the skills and responsibilities of Level 1, and additionally, the
employee is fully knowledgeable of the techniques and practices of heavy equipment use, operation,
and maintenance. The employee is also knowledgeable in road construction, maintenance, and
repair techniques. The employee is capable of operating all Town vehicles and equipment. The
employee can receive general instruction from the road foreman and, with a minimum of
supervision, independently determine the requirements, and accomplish the task. Upon occasion, in
the absence of and/or at the request of the Road Foreman, the Level 2 employee may supervise
fellow workers or others engaged in road maintenance and construction work. A Level 2 worker will
possess working knowledge and understanding of the "Orange Book", a handbook for Local
Officials.
A Level 2 worker may also be asked to perform computer data entry tasks. (refresher training in the
use of Microsoft Word and Excel will be provided if needed)
Evaluation:
The Road Foreman will evaluate Level 1 and Level 2 Highway Maintenance Worker's performance
at least annually.
Performance. in accordance with the Town of Woodbury's Personnel Policy and Procedures and this
Job Description. are the standards against which performance will be evaluated.
Compensation:
The hourly wage associated with the Highway Maintenance Worker position shall be determined by
the Select Board based on qualifications. Information obtained through discussions with the
applicant's references shall be considered as well.
Road crew wage increases are detem1ined by the Select Board after the six-month probationary
period and then on an annual basis.

Town of Woodbury, Vermont
APPLICATION FOR HIGHWAY ROAD CREW POSITION -CDL EMPLOYMENT
(An Equal Opportunity Employer)
Position Applied For: Road Foreman D Road Crew Member D Application Date: _____ _
(Please check one of the boxes)
Applicant Name:
---------------------------------
Last First Middle
· Home Phone Number: Mobile Phone Number:
----------- -----------
Email Address
----------------------------------
Social Security Number: _________ _ Date of Birth:
--------------
Present Address:
---------------------------------
If less than 3 years,
Previous Address:
Street City State Zip code
---------------------------------
Street
EQUIPMENT EXPERIENCE
Dump Truck □No □Yes #of Years __ _
Sanding/Salt D No D Yes # of Years __ _
Excavator
Loader
------
Other
D No D Yes # of Years
D No D Yes# of Years
□ No □ Yes# of Years
DRIVER EXPERIENCE
City
Plowing D No
Grader D No
Backhoe D No
Tractor/Mowing D No
D No
Other
State Zip code
□
Yes# of Years
--
D Yes# of Years
--
D Yes# of Years
--
D Yes# of Years
D Yes # ofYears
CDL License: __________________________________ _
Class 'A'
Class 'C'
State
D Yes# of Years D No
---
□ Yes# of Years □ No
Number
Class 'B'
Expiration Date
D Yes# of Years ____ □ No
List of Endorsements: ______________________________ _
Road Crew Application for Employment -Page 1 of 4 April 12, 2017

ACCIDENT HISTORY
Date of Accident Nature of Accident Injuries or Fatalities Related to Accident
MOTOR VEHICLE VIOLATIONS -OTHER THAN A PARKING VIOLATION
Date of Conviction Offense (be specific)
Has your license (motor vehicle or CDL) ever been suspended, revoked, or denied? □ Yes □ No
If yes, explain the details (including specific violation, timeframe, etc.) __________ _
EMPLOYMENT HISTORY-LIST YOUR LAST THREE (3) EMPLOYERS
EMPLOYER NAME: START END DATE:
DATE:
ADDRESS: STARTING PAY FINAL PAY
TELEPHONE: RATE: RATE:
SUPERVISOR NAME:
YOUR JOB TITLE:
WORK PERFORMED :
REASON FOR LEAVING:
EMPLOYER NAME: START END DATE:
DATE:
ADDRESS: STARTING PAY FINAL PAY
TELEPHONE: RATE: RATE:
SUPERVISOR NAME:
YOUR JOB TITLE:
WORK PERFORMED :
REASON FOR LEAVING:
Road Crew Application far Employment -Page 2 of 4 April 12, 2017

EMPLOYER NAME: START END DATE:
DATE:
ADDRESS: STARTING PAY FINAL PAY
TELEPHONE: RATE: RATE:
SUPERVISOR NAME:
YOUR JOB TITLE:
WORK PERFORMED:
REASON FOR LEAVING:
Have you ever held a position that required DOT alcohol and/or drug testing? □ Yes □ No
If yes, which job? _______________________________ _
SPECIAL SKILLS & QUALIFICATIONS
Summarize special job-related skills and qualifications you have acquired from previous employment
or other experience, including heavy equipment, mechanical, carpentry, computer skills, and any job­
related training received in the United States military.
Describe any special classes or training you have received {such as VT Local Roads classes, flagging
class, certifications, firefighting, or EMT training, etc.)
SUPERVISORY EXPERIENCE -Do you have experience as a:
Lead Crew Member? □ No □ Yes# of Years
---
Supervisor? □ No□ Yes # of Years __ _
If yes, please describe _____________________________ _
EDUCATION
EDUCATION NAME & LOCATION OF YEARS DIDYOU SUBJECTS
SCHOOL ATTENDED GRADUATE STUDIED
High School
Trade, Business or
Other School
College
Road Crew Application for Employment -Page 3 of 4 April 12, 2017

GOALS & REASONS FOR APPLY FOR EMPLOYMENT WITH THE TOWN OF WOODBURY:
------
ADDITIONAL COMMENTS:
REFERENCES
Give the name, address, and telephone number of three (3) references who are not related to
you and who are not previous employers.
l.
Name Address Telephone Number
2.
Name Address Telephone Number
3.
Name Address Telephone Number
I certify that all the information submitted by me on this application is true and complete, and I
understand that if any false information, omissions, or misrepresentations are discovered, my
application may be rejected and, if I am employed by the Town of Woodbury, my employment may
be terminated at any time. I also acknowledge that any employment offer will be contingent on
passing a pre-employment drug screening and physical.
In consideration of my employment, I agree to conform to the Town of Woodbury's, regulations,
policies, and procedures. I agree that my employment and compensation can be terminated, with or
without cause, and with or without notice at any time, at either my or the Town of Woodbury's
option. I also understand and agree that the terms and conditions of my employment may be
changed, with or without cause, and with or without notice, at any time by the Town of Woodbury. I
understand that no Town of Woodbury representative other than the Woodbury Select Board, and
then only when in writing and signed by the Woodbury Select Board, has any authority to enter into
any agreement for employment (including terms related to compensation and/or benefits) for any
specific period of time, or to make any agreement contrary to the foregoing.
Signature of Applicant Printed Name
The Town of Woodbury is on equal opportunity employer. It is the policy of this municipality to provide equal employment opportunity
to oil applicants and employees without regard ta race, color, religion, national origin, sex, sexual orientation, ancestry, place of birth,
age, disability, HIV status, or other status protected by state or federal law. No question is asked an this application or during the
application process far the purpose of excluding any applicant due to race, color, religion, national origin, sex, sexual orientation,
ancestry, place of birth, age, disability, HIV status, or other status under state or federal law.
Raad Crew Application for Employment -Page 4 of 4 April 12, 2017