Encroachment Permit Application

< Encroachment Permit Application

Primary Applicant:

Applicant Name:

Applicant Address:

Applicant Phone:

Applicant Email:

Project Manager:

Project Manager Email:

Location of Work:

Description of Work:

Project Type:

Method:

Width:

Length:

Depth:

Asphalt Cut and Patch Required:

Pre-Con:

Insurance Certificate:

Bond:

Traffic Control Plan:

Testing Required:

State License Number:

Start Date:

Estimated Completion Date:

- All encroachments under this permit shall be in accordance with the applicable Ordinance and laws of City and the State of Utah.

- Any person desiring to encroach of any kind in a public right-of-way (ROW) within the City, shall make application for a permit.

- This permit is not transferable.

- Applicant must restore the surface of any public right-of-way to its original condition as per the City’s standards.

E-Signature:

Site plan/Work plans, Traffic control plan, and Certificate of Insurance

Files