Encroachment Permit Application 7.1.23Please submit to the Engineering Department electronically by emailing the completed application to encroachments@pismobeach.org
rev. 7/1/2023
ADDRESS OF PROJECT LOCATION:
OWNER:
ADDRESS:
CITY/STATE/ZIP:
CONTACT PERSON: TELEPHONE#:
Please check type of telephone: ☐ Cell / ☐ Office / ☐ Home
CONTRACTOR:
ADDRESS:
CITY/STATE/ZIP:
CONTACT PERSON: TELEPHONE#:
Please check type of telephone: ☐ Cell / ☐ Office / ☐ Home
EMAIL:
CONTRACTOR LICENSE #: LICENSE TYPE: EXPIRATION:
CITY BUSINESS LICENSE #:
START DATE: ________________END DATE:__________________USA #:________________________
DESCRIPTION OF WORK:________________________________________________________________
ENCROACHMENT PERMIT SUBMITTAL CHECKLIST (to be filled out by City Employee) All of the following items must be submitted prior to issuance of encroachment permit:
☐ Application (All information completed)
☐ Permit Fee of $248 (Surface), $542 (Subsurface), $74 (minor; not requiring inspection)
☐ Security Deposit Bond (See back for prices) $__________
☐ USA Number
☐ Start and End Date of Project (This may be updated at a later date if necessary)
☐ Proof of Liability Insurance in the amount of $1,000,000.00 naming the City of Pismo Beach as additionally insured
☐ Liability Insurance endorsement sheet
☐ State Contractors License Number and Expiration
☐ Business License with the City of Pismo Beach (Annual Fee Contact Finance Dept.) (One-time Fee $14)
☐ Traffic Control Plan/Pedestrian Control Plan
☐ Signature of Applicant or Contractor on stating that they have read “The Permit” statement under the general provision and
understand the permit requirements
ENCROACHMENT PERMIT APPLICATION ENGINEERING DIVISION
Please submit to the Engineering Department electronically by emailing the completed application to encroachments@pismobeach.org
rev. 7/1/2023
REQUIRMENTS
1. Encroachment Permit Requiring Inspections: Fee $248 (Surface); $542 (Subsurface) Encroachment Permit Not Requiring Inspections: Fee $74 2. Security Bond (See dollar amounts specified below) 3. USA Number 4. Start and End State of Project (This may be updated at a later date if necessary) 5. Proof of Liability Insurance in the amount of $1,000,000 naming the City of Pismo Beach as additionally insured with endorsement sheet attached. 6. State Contractors License Number and Expiration Date. Contractors may only perform work in which their license specializes. General (A: Any Work); Concrete (C-8); Earthwork and Paving (C-12); Parking and Highway Improvement (C-32); Pipeline (C-34) 7. A Business License with the City of Pismo Beach. 8. Traffic Control Plan/Pedestrian Control Plan. 9. Signature of Applicant or Contractor stating that they have read “The Permit” statement under the general provisions and understand the permit requirements.
CALL FOR AN INSPECTION:
24 Hour Advance Notice for all Inspections (805) 773-4656
ALL WORK MUST CONFORM TO CITY STANDARD DRAWINGS – Ask for a copy today!
Notification once traffic control is set up
Prior to placement of dumpster/storage container in street
Upon removal of dumpster/storage container in street
Prior to backfill in trench
Prior to Water Main connection
Prior to Sewer Man connection
Prior to Asphalt/Concrete pour (95% compaction test or 2 sack slurry report due at this time)
Prior to Concrete pour (95% compaction test due at this time; rebar set)
Prior to completion of work for Final Inspection
30 after Final Inspection for Bond Release Inspection
SECURITY DEPOSIT BONDS REQUIRED*
All bonds subject to release 30 days after final inspection
(Contractor/Owner responsible for calling (805)773-4656 for a bond release inspection)
Minor Encroachment Permits
Minimum Bond = $500.00 Surface Encroachment Permits Minor Sidewalk = $1,000 (<20’) Driveway Approach (<16’) = $1,500
Major Sidewalk = $1,500 (>20’) Drive Approach (>16’) = $1,500 + $50 / per foot over 16’ Unimproved City Right-of-Way = $1,000
Subsurface Encroachment Permits
Water (up to 2 inches) or Sewer Lateral (up to 4 inches) = $2,500 Water Main (over 2 inches) or Sewer Main (over 4 inches) = $5,000.00
Street Crane = $1,000.00 minimum
ENCROACHMENT PERMIT REQUIREMENTS & INSPECTIONS