Etna, CA · Siskiyou County

No notary required

Application for Encroachment Permit

This application is for people or contractors seeking permission to excavate, construct, or perform other work in the City of Etna right of way.

What this form is

Use this application to request a City of Etna permit before excavating, constructing, or otherwise encroaching on a city right of way. It asks for the proposed work, dates, site location, applicant and contractor details, and signatures. Work must not start until the permit is issued, and the site must be marked with visible stakes and flags identifying the owner or applicant.

Who needs it

Residents, property owners, or contractors planning work that encroaches on a City of Etna right of way should complete this application.

How to submit it

Send the application to the City of Etna Department of Public Works, 442 Main Street, PO Box 460, Etna, CA 96027. The form lists 530-467-5256.

About notarization

This application is signed without a notary; the applicant and contractor or owner provide signatures, and the applicant dates the form.

How to submit this form

  1. 1

    Download The Application

    Download the City of Etna Application for Encroachment Permit.

  2. 2

    Complete The Application

    Describe the proposed work, dates, location, and applicant and contractor or owner details; provide the requested signatures.

  3. 3

    Gather Plans If Available

    Submit detailed plans if available. They must be submitted if requested by the Public Works Director or representative.

  4. 4

    Send It To Public Works

    Send the application to the City of Etna Department of Public Works at the address listed on the form. Do not start work until the permit is issued.

Frequently asked questions

Do I need a notary for the encroachment permit application?
No. The application has signature fields but no notary block. The applicant signs and dates it; the form also includes contractor or owner signature fields.
How do I submit the encroachment permit application?
Send it to the City of Etna Department of Public Works at 442 Main Street, PO Box 460, Etna, CA 96027. The form lists 530-467-5256.
What information does the application ask for?
It asks for the work type and dates, work-site location, applicant and contractor or owner details, and signatures. Detailed plans should be submitted if available and are required if requested by the Public Works Director or representative.
Can I start work after submitting the application?
No. The form states that this is an application only and that work must not start until a permit is issued.

Need something notarized?

This Application for Encroachment Permit doesn’t need a notary — but if you have another Etna form that does, a commissioned online notary can help.