Type(s)Building & DevelopmentPublic Works Current Applicant Information Information and Documentation Standard Conditions Complete1. Applicant Information 1. Applicant Information First Name Last Name Company / Organization Mailing Address Mailing Address City/Town Province Postal Code Country - Select -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan MarinoSarkSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkmenistanTurks & Caicos IslandsTuvaluTürkiyeU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Primary Phone Number Secondary Phone Number Email Address 2. Dates of Occupancy From Date To Date 3. Detailed Description of Work Detailed Description of Work Please include any required design drawings below. If there difficulties uploading the files please email them to TransportationEngineering@princegeorge.ca. Design Drawings One file only.64 MB limit.Allowed types: pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif, .Please include a copy of your public notification/communication plan to those directly affected adjacent to the work site. Notification / Communication Plan Upload One file only.64 MB limit.Allowed types: pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif, .4. Location of Occupancy Location Type Boulevard Road/Lane Sidewalk Other… Other Location Type Complete Location(s) / Address(es) Length of space required for Occupancy Width of Space required for Occupancy 5. Additional Information Additional Information6. InsurancePlease include copies of your General Liability Insurance of $5 million, listing the City of Prince George as Additional Insured. If there are any difficulties uploading these files please email them to TransportationEngineering@princegeorge.ca. Insurance Upload One file only.64 MB limit.Allowed types: pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif, .7. PaymentAn invoice will be issued for the applicable fees and charges. This is payable at www.princegeorge.ca/ecom, under ‘Pay for Folder,’ the permit number and credit card is required. Or alternatively the invoice can be paid by credit card, cheque or cash at City Hall, Service Centre, or by phone at 250-561-7600; the invoice and permit number are required.Payment must be processed prior to permit approval.AgreementThe personal information on this form is collected by the City of Prince George for the purposes of processing this application, under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection of information, please contact the Supervisor of Transportation at 1100 Patricia Boulevard, Prince George, BC, or by telephone 250-561-7600.Learn more information about the collection of personal information under the Freedom of Information and Protection of Privacy Act.I/WE HEREBY DECLARE THAT ALL THE ABOVE STATEMENTS AND THE INFORMATION CONTAINED IN THE MATERIAL SUBMITTED IN SUPPORT OF THIS APPLICATION ARE TO THE BEST OF MY/OUR BELIEF TRUE AND CORRECT IN ALL RESPECTS. Agreement I agree to and acknowledge all of the terms of this application Applicant's Legal Name CAPTCHA