Right-of-Way Encroachment Permit Application

Application package for state DOT or municipal right-of-way encroachment permits, including applicant details, project location, site plan, bond and insurance, and traffic control attachments.

Applicant Information

• Applicant Organization
• Applicant Type
• Primary Contact Name
• Primary Contact Email
• Primary Contact Phone
• Mailing Address
  Include street, city, state, and ZIP if different from the project location.

Project and Location Details

• Project Name
• Project Description
  Briefly describe the purpose of the work and the encroachment activity.
• Permitting Jurisdiction
• Roadway / Corridor Name
• Project Location
  Provide the nearest address, cross streets, milepost, or stationing as applicable.
• Planned Start Date
• Planned End Date
• Proposed Work Hours
  Example: 7:00 AM to 4:00 PM, Monday through Friday.

Encroachment Scope

• Type of Encroachment
• Utility Type
• Work Method
• Will a lane closure be required?
• Traffic Impact Summary
  Describe anticipated traffic impacts, detours, flagging, pedestrian routing, or access restrictions.

Site Plan and Attachments

• Site Plan
  Upload a plan showing the work area, right-of-way limits, dimensions, utilities, and nearby features.
• Traffic Control Plan
  Upload the proposed traffic control or MOT plan, if applicable.
• Additional Drawings or Exhibits
• Supporting Documents
  Upload any other documents requested by the permitting authority, such as photos, specifications, or work sketches.

Bond, Insurance, and Compliance

• Is a bond required for this application?
• Bond Amount
• Certificate of Insurance
  Upload a current certificate of insurance naming the required additional insureds, if applicable.
• Insurance Expiration Date
• I acknowledge that permit conditions, restoration requirements, and inspection obligations may apply.

Certification and Consent

• Consent to Collect and Use Contact Information
  I consent to the collection and use of my contact information for permit review, approval, and follow-up communication.
• Certification
  I certify that the information provided is accurate to the best of my knowledge and that I am authorized to submit this application on behalf of the applicant.
• Authorized Signatory Name
• Authorized Signatory Title
• Signature