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CITY OF WHITEFISH Public Works Department 418 E. 2nd Street * PO Box 158 Whitefish, MT 59937 Phone: (406) 863-2460 * Fax: (406) 863-2419 $50 Application Fee Required A P P L I C A T I O N F O R T e m p C O N S T R U C T I O N E N C R O A C H M E N T P E R M I T f o r a n y w o r k t h a t d o e s n o t i n v o l v e g r o u n d d i s t u r b a n c e ( i . e . e q u i p m e n t s t a g i n g , r o a d c l o s u r e s , m a t e r i a l s t o r a g e o r t h e u s e o f a d u m p s t e r ) Application for Permit to: (Insert Nature of Permit) 1. Name of Applicant: 2. Address of Applicant: 3. Telephone number of Applicant: 4. Legal Description: Subdivision: Lot(s): Block: Address: 5. Property Owner: (Permittee) 6. Property Owner's Address: 7. If Permittee is a Corporation, give State of Incorporation and names of President and Secretary: 8. Nature of Permit desired (Give sufficient detail to enable thorough understanding. Attach additional pages as may be necessary. Submit all attachments, blueprints or sketches in duplicate.) : 9. Location of installations or structures to be installed: 10. For how long a period is the permit desired: REMARKS: Dated at , Montana, this day of , 20 . Approved By: SIGNATURE OF PROPERTY OWNER (Permittee)