|
DEKALB COUNTY HIGHWAY DEPARTMENT
Permit No.________
APPLICATION FOR ENTRANCE PERMIT
Name_________________________________
Address______________________________ County
Highway Number (If known)_______
Phone____________________________________
Road Name ___________________________________
LOCATION OF PROPOSED ENTRANCE (If known):
Land Section___; Township___North;
TYPE OF ENTRANCE: (Check One)
Range___East of 3rd
Residential_____ Agricultural_____
Commercial_____
Principal Meridian;____________
Township; DeKalb County, Illinois
THE
PROPOSED DRIVE IS DESCRIBED (OR SKETCHED) IN DETAIL AS FOLLOWS:
|
I
CERTIFY ALL INFORMATION TO BE TRUE AND CORRECT AND AGREE TO ACCEPT THE
PROVISIONS THEREOF.
____________________________
Signed
____________________________
Date
|
|
|
PROVISIONS OF ENTRANCE PERMIT:
|
_____________________________________
County Engineer Date |
|
1. The applicant (s) represents all parties in
interest, and that any driveway or approach constructed under this permit
is for the purpose of securing access to their property |
_________________________________________
Field Checked
By
Date |
|
2. No revisions or additions shall be made to the
entrance or its appurtenances on the right-or-way without the written
permission of the County Engineer. |
APPROVED______
DISAPPROVED______
DIMENSION OF PIPE:
Diameter____________ Type/Class ____________
Length ____________ Elevation
_____________
|
|
3. The County reserves the right to make such
changes, additions, repairs, and relocations within statutory limits, to
the entrance (s) or its appurtenances on the right-of-way.
|
Home | Return to top | Subject Index |
Return to Highway |
|