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Encroachment Permit Application

Contact

Phone

Mailing Street Address

Contractor Name

Location of the encroachment

Requested start date

Requested end date

Description of the Encroachment

Types of encroachment

City performed closure

Contractor performed closure

Trailer in parking lane without towing unit attached

Bin, can or material in parking lane

Supply a copy of your site plans

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Agreement

I have read and verified that the information contained within this agreement is correct and understood and agree to all conditions contained within this application.

The City of Prince Albert is committed to protecting your privacy. Personal information collected on this form is in accordance with The Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP) and will only be used for the purpose for which it was collected. Personal information will not be shared or used for any other purpose without your express consent pursuant to LAFOIP and the City of Prince Albert’s policies. Please contact The City Clerk’s office, 1084 Central Ave., Prince Albert, SK, via email cityclerk@citypa.com or call 306-953-4305 for questions about the access, use, and disclosure of your personal information.

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Encroachment Permit Application