Street Occupancy Permit Application

Applicant

Applicant name (company or individual)

Prime contractor (if different from Applicant)

Project owner

Applicant address

Apt/unit #

Street number

Street name

City

Postal code

Contact person

Primary phone

Phone - other

Occupancy details

Expected start date

Expected end date

Expected number of active work/occupancy days

Please specify days and hours of street occupation needs (e.g. Mon-Fri, Saturday only, 8:00am - 3:00pm, 24/7)

Detailed description, including the nature of the work to be completed and a description of all parts of the street to be occupied

(Please note: If pay station/metered parking stall(s) are required, additional rental charges apply. See fee schedule.)

Location - address/approximate address of the proposed work

Is there a possibility for your work to damage any road, sidewalk, or boulevard surface (e.g. drilling holes, excavating, crane lifts, or equipment on sidewalks)? Refer to the damage deposit page for a complete schedule of applicable damage deposit amounts.

Yes No

Permit Number

Provide the related city issued permit number for your work (e.g. municipal access permit, building permit, tree permit, etc.)

Check here if not applicable:

FEES

Refer to the fees page for a complete schedule of applicable fees.

Supplemental attachments (if applicable)

Please note: Maximum file size is 96 MB per file. Maximum total size for all files combined including Supplemental Attachments (below) is 96 MB.

Traffic Management Plan

Proof of Insurance

Prime Contractor Designation Form

Click here to download Prime Contractor Designation Form

Other documents (if more than one, please update in a ZIP file)

Acknowledgement

I confirm that all information I have provided is true and accurate to the best of my knowledge. I have read and understood the requirements for this permit and Part 5 (Permits) of the City of New Westminster's Street and Traffic Bylaw No. 7664 and agree to the terms and conditions as stated on the Street Occupancy Permit. I acknowledge that obtaining a Street Occupancy Permit does not absolve me from acquiring or following the requirements and conditions of any other necessary permit. If I have any questions or concerns I will contact the issuing department at 604-527-4592.

I acknowledge that the City reserves the right to amend or vary a Street Occupancy Permit at any time, suspend or revoke the permit for reasons of public safety, or if permit holder fails to comply with the terms and conditions of the Permit.

This information is collected by the City of New Westminster under Section 26(c) of the Freedom of Information and Protection of Privacy Act and will be used for administration of street occupancy permits. Should you have any questions about the collection of this personal information please contact the FOI and Privacy Coordinator, 511 Royal Avenue, New Westminster, V3L 1H9, or send an email to .

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