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Encroachment on Municipal Roadways
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1.
Personal Information
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2.
Request for:
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3.
Authorization
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Personal Information
Moving Containers/Refuse Bins/Landscaping Materials on Municipal Roadways
Full Name
*
Email
*
Address
*
Contact Phone Number
*
City
*
Province
*
Postal Code
*
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Request for:
Type of Encroachment:
*
-- Select One --
Moving Container
Disposal Bin
Landscaping Materials
Size of Container or Bin:
List Type of Landscaping Materials:
Address of Encroachment
*
Reason for placement on roadway. Why can item(s) not be placed on private property:
*
Once submitted, application processing will take between 5-7 business days. Encroachment will not be allowed until an approved permit has been provided to the applicant by the City.
Date(s) item will be on Roadway:
*
Date(s) item will be on Roadway: Start Date
—
Date(s) item will be on Roadway: End Date
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Authorization
In accordance with Section 8 of Beaumont’s Traffic Safety Bylaw #834-14:
-Moving containers/refuse bins/landscaping materials placed on roadways or driveways extending over the sidewalk MUST be marked with reflective coating/striping/reflectors on the containers/landscaping materials with pylons, barrier or tape to alert traffic and pedestrians.
-Moving containers/refuse bins/landscaping materials MUST NOT obstruct local traffic or emergency service vehicles, interfere with any nearby driveway or sidewalk (unless otherwise stated), manholes, main water valves or be placed within five (5) meters of any fire hydrant.
-Roadway MUST been fully cleaned, swept and free of any remaining landscaping materials or debris.
-Your approved application MUST be available upon request from Municipal Enforcement, RCMP, Fire and Public Works or other authorized City Employee.
-Any damage to City property as a result of this request will be borne by the Applicant.
-The Applicant will hold the City Employees & Agents harmless in the event of any injury or damage as a result of the Applicant’s request.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 4)I have read all the above and agree to follow Section 8 of Beaumont's Traffic safety Bylaw #834-14. 5)I certify that the information given on this form is true and complete to the best of my knowledge and acknowledge my authorization of the information to be used for the purposes identified below.
I agree.
Electronic Signature
Date:
Date:
The personal information requested on this form is being collected under the authority Section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act. The information collected will be used as required/for the purpose of processing special permissions. If you have any questions about the collection or use of your personal information, contact the City of Beaumont’s FOIP Coordinator at 5600-49th Street, Beaumont, Alberta, T4X 1A1 or 780-929-1356.
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