Driveway Permit Application

Block __________ Lot ____________ Date ____________

Street location_______________________________________________________________

Owner name________________________________________________________________

Address____________________________________________________________________

Telephone No: Work_____________________ Home_______________________

Plan prepared by:_____________________________________________________________

Address:____________________________________________________________________

Telephone No:_______________________________________________________________

Proposed construction: (check one)

New driveway_________

Alteration___________

A plot plan of the site showing elevations and the proposed driveway must accompany the application.

Contractor:__________________________________________________________________

Address:____________________________________________________________________

Telephone No:__________________________________

Upon approval of the Driveway Permit, you will be given the Ordinances #28-80 and #46-87 entitled “Driveway Standards for Single Family Residences”.

Name____________________________ Signature________________________________

OFFICE USE ONLY

Review comments:____________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Approved by:___________________________________ Date_________________________