HomeMy WebLinkAbout2017 Driveway Permit Application Lot 2-3 TOWN OF NORTH VER - DIVISION OF PUBLICWORKS
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 bight-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,
3
Please legibly fill out the following Information completely (blue or black Ink)
J ,-
Date of Application; � Owner:
Address. 2 t .3 `>�.� 121` Phone;, `1I I
.— - - _.._ >-�- V
Are Town trees Involved Y / Compliance with MGL Chapter 87 required Y / N
Are Town Boards involved? Y,)/ N If yes, which Board(s) (' <N-fseq.v- -hor-r - dr"-)j rf-I vi
Building Permit? Y / N Copy of Permit attached? Y / N
Approved plan attached? Y / N Proposed plans submitted? Y / N
Driveway information
New Existing New driveway sq ft Expansions ft Existing s ft
q g q
Can you show the location of water service shut off Y / N or /`AY NfA due to Well is in use
Storm water runoff flows to the street right-of-way? Y 1 C �- r` i f'° fit` �� °r°t �' ` .
Work to be done in right-of-way? / N If yes, describe
Runoff mitigation (1.e, Infiltration, grass areas, change grades, etc) provided? / N If yes, describe
Contractor Information: Name; �.. v �k,t y pc V�_
'e � -
Address: , - �...�...�.. Phone(s); `l -1 V
This portion to be filled out by the town r,6Kr*KM
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Approved by: Date: �� 'ZS �? Final Inspection Date:
Completed by:
1
TOWN OF NORTH ANDOVER - DIVISION OF PUBLIC
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 roadways 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: I /f l u Owner;
Address: 1 V i a «rv� S+. Phone:
Are Town trees involved Y / N Compliance with MGI. Chapter 87 required Y / N
Are Town Boards involved?�Y?/ N If yes, which Board(s)
Building Permit? Y / N Copy of Permit attached? Y / N
Approved plan attached? Y / N Proposed plans submitted? Y / N
Driveway information
New L Existing New driveway sq ft Expansion sq ft Existing sq ft
Can you show the location of water service shut off Y / N or N/A due to Well is in use
Storm water runoff flows to the street right-of-way? Y / k) 6 (14r "; $ }
Worst to be done in right-of-way? �1 N If yes, describe
Runoff mitigation (l.e. infiltration, grass areas, change grados, etc) provided? Y? 1 N If yes, describe
Contractor Information: Name: r_ ,�,;; �,� � .t fe.
This portion to be filled out by the town 1-" V4V0'M
- Arzvv b5: �
Approved by: VhE\ Date: id z� t7 Final Inspection Date:
\_/ \j V(C mpleted by: