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APPLICATION FOR ENCROACHMENT PERMIT

KENTUCKY TRANSPORTATION CABINET Department of Highways PERMITS BRANCH TC 99-1A Rev. 10/2020 Page 1 of 4 APPLICATION FOR ENCROACHMENT PERMIT KYTC KEPT #: SECTION 1: APPLICANT CONTACT INFORMATION APPLICANT ADDRESS EMAIL CITY STATE ZIP CONTACT NAME 1 EMAIL PHONE # CELL # CONTACT NAME 2 (if applicable) EMAIL PHONE # CELL # SECTION 2: PROPOSED WORK LOCATION ADDRESS CITY STATE Kentucky ZIP COUNTY ROUTE # MILE POINT LONGITUDE (X) LATITUDE (Y) ADDITIONAL LOCATION INFORMATION: FOR KYTC USE ONLY PERMIT TYPE.

The permit, including this application and all related and accompanying documents and drawings making up the permit, remains in effect and is binding upon the Applicant/Permittee, its successors and assigns, as long as the encroachment(s) ... the general public.) ... encroachment away from the surrounding right‐of‐way and the travel way of ...

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