Encumbrance Permit

Terms and Conditions:
1. Thoroughly read and understand all conditions including insurance needs, plans, contacts
2. At least 48 hours notice
3. Applicant must either mail, e-mail or fax us a well drawn out map with north arrow, streets, and sign placement, traffic detours and personnel
4. Applicant must contact Police, Fire, MTA and Parking Administrator
5. No work may proceed without the approved permit in hand.
6. Applicant must either come in and pay by cash or check, pay by mail, or some other way, before they can get any permit.

In order to change or update your application please contact the Highway Department.

Once your application has been reviewed, you will be contacted (email, phone) regarding permit status.

Agree to Terms	I agree to these terms
Company Name
Company Street Address
Company City
Company State
Company Zip
Company Phone Number
Company Cell Number
Propose Blocking	Street Sidewalk
Encumbrance Street Number
Street of Encumbrance
From (Location)
To (Location)
Reason for Encumbrance
Start Date
End Date
Your Last Name
Your First Name
Email
Telephone
Fax
	Submit Cancel