Please fill out the required information and submit with a sketch of driveway to Town Clerk.

1. Applicant name _______________________________________2. Phone number_________________3. Date___________

4. Applicant mailing address _________________________________________________________________________________

5. Property owner name (if not applicant)_____________________________________________________6. Fee $200.00

7. Type of driveway (check one): new________ improve existing________ relocate existing___________

8. Residential or Commercial ?_________ 9. Completion date*__________________________________

10.Address for proposed driveway (or parcel number)______________________________________________________

11.What is the current zoning and intended land use of this property?__________________________________________________

_______________________________________________________________________________________________________

12. Are there any restrictions or easements across this property, recorded or not?_________________________________________

_______________________________________________________________________________________________________

13. Will any segment of proposed driveway disturb land with a grade of more than 10%? __________________________________

_______________________________________________________________________________________________________

14. Please specify roadbed base, including depth and material________________________________________________________

_______________________________________________________________________________________________________

15. Please specify erosion control procedures (if required)___________________________________________________________

_______________________________________________________________________________________________________

* If driveway is not completed by “Completion date” specified, a time extension must be obtained from the
Driveway Inspector or this Permit is null and void and the driveway shall not be constructed unless authorized
through a subsequent permit.

The construction and maintenance of the driveway shall be the responsibility of the applicant. It is understood and agreed that approval is subject to the applicant’s full compliance with all requirements, fees, and specifications as stated in the Town of Calamus Driveway Ordinance and Fee Schedule. The applicant shall also comply with all permit provisions, superimposed notes and drawings, which may be added by the Town Board or Driveway Inspector.

Notes: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Property Owner/Authorized Signature) (Date)

Applicant shall place flags outlining the proposed driveway. Also provide a sketch of proposed driveway on the back of this application.
To be completed by Town Board

Permit Approved______ Denied______ Date______________________ Authorization____________________________

Issuance Understandings/Reasons for Denial______________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________

Inspections:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Date Final Inspection Completed:_______________Inspector Signature________________________________________________

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