This application must be submitted to begin the encroachment permit/license process. A completed application must be submitted to begin the process. You will be contacted by Engineering staff to complete the process.

RESIDENTIAL CONTACT INFORMATION

1

Property owner name

 *

Property owner name

2

Phone

 *

Phone

3

Email

 *

Email

4

Property address

 *

Property address

5

City, State, Zip code

 *

City, State, Zip code

6

Address or street name of encroachment:

 *

Address or street name of encroachment:

7

Description of encroachment and type of material used:

 *

Description of encroachment and type of material used:

8

Dimensions or square footage of right-of-way impacted by encroachment:

 *

Dimensions or square footage of right-of-way impacted by encroachment:

9

Full legal description of property address to proposed encroachment:

 *

Full legal description of property address to proposed encroachment:

10

SIGNATURE

 *

SIGNATURE

11

DATE

 *

DATE

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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