HomeMy WebLinkAbout2018-02-20 Driveway Permit 203 Mill Road LDP TOWN OF NORTH A,NDOVER - DIVISION OF PUBLIC WORKS
Permit to Connect a Driveway to the Town Right-of-Way
Permit to be issued at each building permit signed
This Permit only approves connection to the Town Right-of-Way and not the overall
driveway design. Approval from Conservation or other Town Boards may be required.
The pavement elevation of all driveway entrances must be at least 4 inches below the edge of the
existing roadway's pavement at a distance of 6 feet from that edge of pavement into the roadway
shoulder.
Please legibly fill out the following Information completely (blue or black ink)
Date of Application: 611E tg Owner: LUZ
Address: Za A Phone: a�'Z- -I/)h
Are Town trees involved Y /(3 Compliance with MGL Chapter 87 req ire Y /(N)
Are Town Boards involved/ N If yes, w ' h Board(s)
r
Building Permit? Y / N u Copy of Permit attacked' ? Y N
Approved Ian attached I ails su mitted? Y N
pp p o I Z= /
Driveway information
New Z4 Existing New driveway sq ft Expansion sq ft Existing sq ft
Can you show the location of water service shut off Y f N or N/A due to Well is in use
Storm water runoff flows to the street right-of-way? Y / N
Work to be done in right-of-way?C-Y-1)/ N If yes, describe
Runoff mitigation (i.e, infiltration,grass areas, change grades,etc) provided?oy ,
N If yes, describe
M- Oek'�
Contractor Information: Name:
Address: )f V9 Phone(s): _ 2 -n` 1
This portion to be filled out by the town
Approved by: Date: r^oi� Final Inspection Date:
Completed by: