Encroachment On-line Application
APN: 
Situs Address: 
Location   -   N    S   E   W   of (Intersecting road or landmark)::

Owner:

Address:

Address Line 2:

City:

State:

Zip Code:

Phone:

Email:

Applicant:

Address:

Address Line 2:

City:

State:

Zip Code:

Phone:

Email:

General Contractor:

Address:

Address Line 2:

City:

State:

Zip Code:

Phone:

Email:

Application is made for permission to excavate, construct and/or otherwise encroach on county right of way by performing the work described below:

Description of Work::

Estimated cost of work in right of way:  

Attach plans (show location, dimensions, etc.  Include all pertinent information).
Attach traffic control plan if applicable.
Attach work schedule (include hours, days and what will take place each day).

Attachments:

Upon Submittal, 
Applicant agrees to abide by the conditions of this permit and its provisions.  Applicant also acknowledges that the permit will expire within one year if construction has not been completed and no extension has been requested.