RICHFIELD CITY CORPORATION
Roadway/Right-of-Way Encroachment Permit
(Applicant) hereby applies for a permit to encroach upon a
right-of-way within Richfield City known as
for the purpose of .
Said encroachment is proposed at the following location upon said right-of-way:
and is described as
Applicant proposes work to begin on and to be completed on or before
Applicant agrees to comply with all laws, ordinances, and regulations of all governmental agencies,
including Richfield City Corporation, as well as instructions of the Richfield City Public Works
Supervisor or his assigned representative.
Applicant signature
Title Date
Applicant address Phone Number
Person to Contact on Job Site Phone Number
Office Use Only
Permit Approved
Date
Permit Fee: $50.00 plus $.50 per square foot of trench for paved areas.
$.25 per square foot of trench for unpaved areas.
Cash Bond Amount: $2000.00 minimum