COVID Encroachment Application Package 8.6.20rev. 8/5/2020
In order to support our local businesses during this difficult time, the City will be allowing restaurants to close
portions of the right of way so that social distancing can be achieved. Should you wish to utilize the right of
way for line queuing or additional dining space, please fill out the following application and submit requested
documents listed at the bottom of this page. Once application and supplemental documents have been
emailed to Erin Olsen at eolsen@pismobeach.org, you will receive a confirmation email that your application
was received. Once application is reviewed and approved you will receive an email requesting your signature
on the approved permit. Please sign and send back a copy via email. Note that your permit is not valid without
your signature on the approved permit.
BUSINESS:
ADDRESS:
TELEPHONE #:
OWNER:
ADDRESS:
CITY/STATE/ZIP:
CONTACT PERSON: TELEPHONE#:
Please circle type of telephone: Cell / Office / Home
START DATE: ______________________________ ___END DATE:______________________________
HOURS OF OPERATION: ________________________________________________________________
BUSINESS LICENSE NUMBER: ___________________________________________________________
Please circle yes if furniture is being placed in the right of way: Yes / No
DESCRIPTION OF USE (i.e. Dining or Line Queuing): ________________________________________
PERMIT SUBMITTAL REQUIREMENTS/CHECKLIST (to be filled out by City Employee)
All of the following items must be submitted prior to issuance of permit:
Application (All information completed)
Business License with the City of Pismo Beach
Exhibit of Area Requested to be used – Please submit a sketch over aerial imagery showing limits of use
Pedestrian Control Plan – if necessary, for routing pedestrian traffic around dining space
Proof of Liability Insurance in the amount of $1,000,000 naming the City of Pismo Beach as additionally
insured
Liability Insurance Endorsement Sheet
Liability Waiver Signed
Terms and Conditions Signed
COVID-19 SUPPORT
DINING ENCROACHMENT PERMIT APPLICATION
Email application to eolsen@pismobeach.org
BE SMART. STAY APART.
Visit www.pismobeach.org/CovidResponse
rev. 8/6/2020
BUSINESS NAME _______________________________ PERMIT NUMBER_____________________
To be eligible for this program, all private areas allowed to be opened by local and State guidelines
must be utilized for dining.
Applicant is responsible for providing an exhibit to the City of Pismo Beach identifying the space
to be utilized for dining.
Applicant shall indemnify the City of Pismo Beach and name the City as additionally insured.
Applicant is responsible for providing and maintaining trash receptacles within their dining area.
Applicant is responsible for keeping their dining area clean at all times.
Applicant is responsible for the cost and installation of K-rail and other items necessary for
pedestrian safety.
No access shall be granted into the dining area from the street, access shall only be granted from
the sidewalk.
Applicant must follow local, County, and State requirements.
Applicant is responsible for giving a written notification to customers to use the marked crosswalk
to access the dining space, should that space be located on the opposite side of the street.
ADA requirements shall be met at all times.
Applicant is responsible for providing ADA compliant pedestrian traffic control through the area.
Permit may be revoked by the City for violation of terms.
No markings, except non-residue tape (such as stucco tape), will be allowed on City sidewalk.
Duct Tape is prohibited from being used in the City right of way.
Applicant is liable for any damage within the City right of way.
This permit shall be valid for 30 days. Applicant is responsible for renewing at the end of each 30-
day period.
Additional Requirements for Shell Beach Road Corridor:
Applicant shall not place furniture or allow dining within City right of way until Shell Beach
Streetscape project’s heavy equipment is removed from the corridor.
Applicant is responsible for suspending their services in the right of way to allow for construction
activates to continue when given notice by City staff.
Applicant shall only place tables in locations as approved by the City.
PRINTED NAME ______________________________________________________________________
SIGNATURE________________________________________ DATE________________________
COVID-19 SUPPORT
DINING ENCROACHMENT PERMIT
TERMS AND CONDITIONS
BE SMART. STAY APART.
Visit www.pismobeach.org/CovidResponse
rev. 8/5/2020
BUSINESS NAME _______________________________ PERMIT NUMBER_____________________
Permittee hereby agrees to indemnify and hold harmless the City of Pismo Beach (“City”), its Council,
officers, boards, commissions, agents and employees of and from any and all claims, suits or actions of
every name, kind and description which may be brought against City, its Council, officers, boards,
commissions, agents, or employees by reason of any injury to or death of any person or damage suffered
or sustained by any person or corporation, caused by, or alleged to have been caused by, any act or
omission to act, negligent or otherwise, of Permittee, its officers, agents or employees in connection with
the use and/or occupancy of the area subject to the Encroachment Permit issued to Permittee.
The duty of Permittee to indemnify and hold harmless, as set forth herein, shall include a duty to defend
as set forth in Section 2778 of the California Civil Code; provided, however, that nothing herein shall
be construed to require Permittee to indemnify City, its Council, officers, boards, commissions, agents
and employees against any responsibility or liability in contravention of Section 2782 of the California
Civil Code.
Permittee, at its sole cost and expense, shall acquire and maintain in full force and effect throughout the
term of this Permit commercial general liability insurance coverage relating to Permittee's use and
occupancy of the permitted area covering City's risks in form subject to the approval of the City Attorney.
Permittee acknowledges that the encroachment permit associated with this liability waiver may be revoked
at any time without notice should the Permittee fail to abide by City ordinances, resolutions, or other
regulations.
PRINTED NAME ______________________________________________________________________
SIGNATURE________________________________________ DATE________________________
COVID-19 SUPPORT
DINING ENCROACHMENT PERMIT
LIABILITY WAIVER
BE SMART. STAY APART.
Visit www.pismobeach.org/CovidResponse