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Run: Right-of-Way Encroachment Permit Application

Right-of-Way Encroachment Permit Application template for submitting road, sidewalk, or utility work in public right-of-way. Capture project details, traffic...

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Applicant Information

Applicant Organization (required)

Applicant Type (required)

Primary Contact Name (required)

Primary Contact Email (required)

Primary Contact Phone (required)

Mailing Address

Include street, city, state, and ZIP if different from the project location.

Project and Location Details

Project Name (required)

Project Description (required)

Briefly describe the purpose of the work and the encroachment activity.

Permitting Jurisdiction (required)

Roadway / Corridor Name (required)

Project Location (required)

Provide the nearest address, cross streets, milepost, or stationing as applicable.

Planned Start Date (required)

Planned End Date (required)

Proposed Work Hours

Example: 7:00 AM to 4:00 PM, Monday through Friday.

Encroachment Scope

Type of Encroachment (required)

Utility Type

Work Method

Will a lane closure be required? (required)

Traffic Impact Summary

Describe anticipated traffic impacts, detours, flagging, pedestrian routing, or access restrictions.

Site Plan and Attachments

Site Plan (required)

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? (required)

Bond Amount

Certificate of Insurance (required)

Upload a current certificate of insurance naming the required additional insureds, if applicable.

Insurance Expiration Date (required)

I acknowledge that permit conditions, restoration requirements, and inspection obligations may apply. (required)

Yes No N/A

Certification and Consent

Consent to Collect and Use Contact Information (required)

I consent to the collection and use of my contact information for permit review, approval, and follow-up communication.

Yes No N/A

Certification (required)

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.

Yes No N/A

Authorized Signatory Name (required)

Authorized Signatory Title (required)

Signature (required)

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