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Driveway Permit

2. Applicant Information

3. Driveway Permit Fee:
   $25.00 (if submitting with a new house permit, the two fees can be paid together with one check/cash)

   $25.00 (if submitting with a new house permit, the two fees can be paid together with one check/cash)

4. Permit Number

6. Applicant Name:

8. Address:

10. City:

11. State:

12. Zip Code:

16. Property Location & Information

18. Address:

20. City:

21. State:

22. Zip Code:

24. Subdivision:

25. Lot Number:

29. Installations

31. Installation Description:

    1. New Access
    2. Existing Upgrade
    3. Non-Curb & Gutter

32. Non-Curb & Gutter - Distance from Utility Boxes, Fire Hydrants, Catch Basin:

    Minimum 8 feet.

36. Piping

38. Culvert Pipe:

    1. Steel
    2. Concrete
    3. Other

39. Pipe Length:

    Minimum 30 feet.

43. Driveway

45. Driveway Width:

49. Drive Apron & Intersection

51. Drive Apron Material:

    1. Concrete
    2. Pavers
    3. Asphalt
    4. Gravel

52. Intersection:

    1. N/A
    2. Minor
    3. Major

53. Intersection Distance:

    Minimum 50 feet minor, 200 feet major.

57. Applicant Signature:

58. Date:
    Date:

Leave This Blank:


60. Submit

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