Driveway Permit Application

Date:____________________Permit Fee $25.00 (Payable to Elk Grove Highway Dept.) Permit Number:____________

Name:_________________________Address:____________________________City:______________Zip:_________

Certificate of Insurance has been furnished by:____________________________$______________Bond has been furnished to cover all damage to existing streets, structures, or overhead or underground facilities.

This permit is granted under the following conditions. Failure to comply may result in a fine or revocation of this permit.

The construction of a concrete driveway is to be two (2) feet back from the edge of the Township blacktop roads, and this area is to be filled with blacktop level with the road. Blacktop driveways must also be made level with the road.

Before any work on the driveway is started the area must be surveyed. The plans should be given to the Highway Commissioner for approval and this permit issued.  The Commissioner must inspect the driveway before and after it is completed.

All driveways, concrete, blacktop or stone, shall have a 12" diameter culvert pipe go under it at the ditch line. Any variation to this diameter must be determined by the Highway Commissioner. The cost of the pipe is to borne by the permit holder.

Any installations not requiring a culvert pipe can only be determined and approved by the Highway Commissioner.

All existing and functioning drain tile must be repaired and restored to operating condition.

All streets must be kept open while construction work is in progress and all necessary precautions must be taken to safeguard the public by use of barricades, signs, or flagmen at all times.

All streets must be repaired by use of satisfactory sand fill or equivalent materials and the surface must be repaired using material equal to or better than existing surface material. Damage to any other public or private facilities must also be repaired.

All liability and responsibility caused by accidents and infringement on private or public property shall be responsibility of the contractor doing the work. 

All trucks used to transport materials to or from the construction site must comply with all laws as to operation. (Overweight, etc.)

This permit is valid only on streets or right of ways of said streets for which the plats and plans of said work have been submitted to the Highway Commissioner.

Contractor:________________________________________________Bond Number:_____________________            

Address:___________________________________________________________Telephone:________________

Date plans received:___________________Date permit granted:______________Permit valid until:____________

Permit granted by:_________________________________________________ 

                           Charles Serchuk, Elk Grove Township Highway Commissioner