Legal Encroachment Permit Application

LEGAL ENCROACHMENT PERMIT APPLICATION

Applicant Name:    Applicant Address:

Issuing Authority:    Project Address/Location:

RECITALS

WHEREAS, Applicant desires to construct, place or maintain a physical improvement, material, or use (the "Encroachment") within or over that portion of the public right-of-way or other property under the control of Issuing Authority, as more particularly described below; and

WHEREAS, Issuing Authority has the authority to regulate use of the right-of-way and to grant permission for encroachments subject to conditions that protect public safety, access, maintenance, and municipal operations; and

WHEREAS, the parties desire to set forth the terms and conditions under which Issuing Authority will permit the Encroachment on the terms set forth in this Permit.

NOW THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this Permit, the following terms shall have the meanings set forth: "Encroachment" means the structures, improvements, materials or uses listed in Section 3 that occupy space within or over property controlled by Issuing Authority; "Permit" means this Encroachment Permit Application and the approval issued by Issuing Authority; "Authorized Representative" means the person designated in writing by Issuing Authority to administer and inspect the Permit.

2. PERMIT GRANT

Subject to the terms and conditions of this Permit and upon payment of required fees and provision of insurance and security, Issuing Authority grants Applicant a revocable, non-exclusive permit to install, construct, and maintain the Encroachment described in Section 3 at the location identified in this Application. This Permit does not convey any property interest or easement.

3. DESCRIPTION OF ENCROACHMENT

Type of Encroachment (check all that apply):

Encroachment Types: Sidewalk expansion    Landscaping    Fence    Driveway apron    Signage    Utilities    Other:

Encroachment Dimensions: Length    Width    Area

4. STANDARDS AND CONDITIONS

Applicant shall perform and maintain the Encroachment in a manner that does not unreasonably interfere with pedestrian or vehicular traffic, drainage systems, utility facilities, or municipal operations. All work shall conform to applicable design standards, specifications, and any conditions imposed by Issuing Authority. Applicant shall obtain any additional permits required by law prior to commencement of work.

5. MAINTENANCE, INSPECTION, AND REMOVAL

Applicant shall, at its sole cost and expense, maintain the Encroachment in a safe, neat and operable condition. Issuing Authority may inspect the Encroachment at reasonable times. If Issuing Authority determines that the Encroachment constitutes a hazard or is not maintained in accordance with this Permit, Issuing Authority may require correction or removal. Applicant shall promptly comply with any such directive and, if Applicant fails to act within the time prescribed, Issuing Authority may perform the work at Applicant’s expense.

6. INSURANCE AND INDEMNITY

Applicant shall procure and maintain insurance in such form and with limits acceptable to Issuing Authority. Applicant shall name Issuing Authority as an additional insured for claims arising out of the Encroachment. Applicant agrees to defend, indemnify and hold harmless Issuing Authority, its officers, employees and agents from and against any and all claims, liabilities, losses, damages and expenses, including attorneys' fees, arising out of or related to the Encroachment, except to the extent caused by Issuing Authority’s gross negligence or willful misconduct.

7. FEES AND PERFORMANCE BOND

Applicant shall pay the applicable permit fee and shall provide a performance bond or other security in an amount sufficient to guarantee performance of maintenance and removal obligations. Fees are non-refundable unless expressly provided.

8. TERM; TERMINATION

This Permit shall commence on the date of issuance by Issuing Authority and shall continue for the period specified in the issued Permit or until revoked pursuant to the terms hereof. Issuing Authority may terminate or suspend this Permit immediately if Applicant fails to comply with any material term or condition of this Permit, or if continued maintenance of the Encroachment poses an imminent threat to public safety.

9. COMPLIANCE WITH LAW

Applicant shall comply with all federal, state and local statutes, ordinances and regulations applicable to the Encroachment and any related construction or maintenance activities. The issuance of this Permit does not relieve Applicant of the obligation to obtain other permits or approvals required by law.

10. NOTICES

All notices required or permitted under this Permit shall be in writing and delivered to the addresses below by personal delivery, certified mail, or other method providing proof of delivery.

11. AMENDMENTS; WAIVER; SEVERABILITY

Any amendment to this Permit must be in writing and signed by both parties. Failure by either party to enforce any provision of this Permit shall not constitute a waiver of that provision. If any provision of this Permit is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

12. GOVERNING LAW; ENTIRE AGREEMENT

This Permit shall be governed by and construed in accordance with the laws of the state in which the Issuing Authority has jurisdiction. This Permit, together with any documents incorporated herein by reference, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, understandings, or agreements.

CERTIFICATION

Applicant hereby certifies under penalty of perjury that the information in this Application is true and correct, that Applicant has authority to request this Permit, and that Applicant will comply with all terms and conditions of this Permit if granted, including payment of fees, provision of insurance and bonds, and indemnification obligations.

SIGNATURES

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