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Encroachment Permit

  1. City of Bay City Encroachment Permit
  2. Encroachment Address Type*
  3. Duration*
  4. Space and Construction Requirements*

    Select all that apply

  5. Property Owner Information
  6. Permit Applicant Information
  7. Contractor Information
  8. Requirements

    The certificate and policy of insurance shall be endorsed and the following language must be included:

         "The City of Bay City, its officers and employees are additional insureds.  This coverage is primary to the City and not contributing or pro rata with any other insurance or similar protection which is or may be available to or carried by the City."

    Dumpster and Sign Companies must be licensed with the City Clerk's office.

    See examples below for more information.

  9. Encroachment Insurance Requirements
  10. Additional Insured
  11. Term of Insurance (As long as the Certification of Liability Insurance in compliant with the City of Bay City's Encroachment Policy stated below)
  12. Applicant Agreement*
    The Applicant agrees to comply with all the terms and conditions of the City's Encroachment Policy and any encroachment permit which may be issued as a result of this application. Applicant further understands and agrees that the City in its discretion may approve, deny, or set any limitations on any encroachment permit which may be issued, or may at any time modify, rescind or revoke any permit for the use of the City's property by the Applicant, all without recourse or remedy by the Applicant, or liability of the City. By granting permission to use or occupy the City’s property for the stated purpose, the City is only granting Permittee a mere license. Permittee shall waive, release and relinquish any and all claim of right, title or interest in the City’s property or ROW. In the event that the property's use is changed or the property is sold, transferred or otherwise conveyed by the Applicant or Owner, the encroachment permit shall expire. In the event that the Applicant fails to comply with any of the conditions or agreements set forth above or in the City's Encroachment Policy, or fails to maintain the encroachment in good condition and repair, in compliance with all applicable state law and City ordinances, including building codes and regulations, then this encroachment permit shall automatically expire and Applicant shall immediately remove the encroachment. There shall be no work prior to approval of the permit and 3 business days' notice to the Engineering Division. The permittee states that he/she has full authority to execute this application on behalf of the owner and acknowledges receipt of a copy of the City's Encroachment Policy and agrees to comply with all terms and conditions set forth therein.
  13. Leave This Blank:

  14. This field is not part of the form submission.