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Permit Applications
Encroachment Permit Application
Encroachment Permit Application
Encroachment Permit Application
I. GENERAL INFORMATION
Date
MM slash DD slash YYYY
Permit Number (Office Use Only)
Name of Applicant
*
First
Last
Address of Applicant
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
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Oregon
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South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Name of Property Owner
First
Last
Type of Permit Requested:
Length of Time Requested for Permit:
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.
Copy of Insurance or Special Endorsement Form
*
Max. file size: 64 MB.
II. SITE INFORMATION
Describe Location of Requested Encroachment:
Adjacent Streets, Measurement of Sidewalks, Distance from Streets or Alleys:
Describe Requested Encroachment Completely:
What is it? What does it include? (measurements, contents on sign, etc):
Maximum Height of Encroachment:
Maximum Width of Encroachment:
Approximate Square Footage of Encroachment:
Describe any construction that will take place:
III. SITE PLAN
Upload Site Plan
Max. file size: 64 MB.
Date
*
MM slash DD slash YYYY
Name
*
First
Last
Completing this field serves as your signature and that the information presented is to the best of your knowledge.
Applicant's Email
*
Enter Email
Confirm Email
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