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City Office: 515-832-9151 | Utility Office: 515-832-9141

Encroachment Permit Application

Encroachment Permit Application

  • I. GENERAL INFORMATION

  • Date Format: MM slash DD slash YYYY
  • 1. Provide a copy of Insurance Certificate or Special Endorsement Form with Application releasing the City, its elected boards, officers, agent and employees from liability or the above mentioned as being additionally insured). 2. Either the City or the permit holder may terminate permit by giving the other party thirty (30) days written notice.
  • II. SITE INFORMATION

  • III. SITE PLAN

  • Date Format: MM slash DD slash YYYY
  • Completing this field serves as your signature and that the information presented is to the best of your knowledge.