Encroachment Permit Encroachment Permit Application Name of Applicant (Individual/Owner) First Name (required) Last Name (required) Phone (required) Email (required) Property Address Street Address (required) Address Line 2 City (required) State (required) Zip Code (required) Requested Start Date (mm/dd/yyyy) (required) Requested Start Time (HH:MM AM/PM) (required) Requested End Date (mm/dd/yyyy) (required) Name of Contractor (If Applicable) First Name Last Name Contractor Address (If Applicable) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country Contractor State License Number (If Applicable) Location of Encroachment Reason for Encroachment Type of Vehicle(s) accessing District Property or Right of Way Has work commenced or encroachment occurred prior to receiving permit? Yes No There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
