Curb Cut/Driveway Application

• Permit No.
• Date

Application is hereby made by the undersigned for permission to construct and keep in repair:

• A driveway approach to: Private Land / Proposed Public Highway
• Town Road Name
• Town of
• Location of Proposed Access
• Describe are to be served
• Describe future planning for this area
• Proposed top surface material if any
• Proposed Driveway width (20' Min.)
• Remarks

The undersigned applicant hereby agrees to the conditions and responsibilities as given on this application. (see other side)

• APPLICANT'S Signature
• Owner
• Address
• Date work to begin
• Phone #
• Name of Contractor
• Approved Ditch Crossing Pipe Diameter (See #17 on other side)
• Length(40' Max.)
• Type (See #5 on other side)
• Bedding Material
• Driveway width at Crossing

• PERMIT EXPIRES
• This PERMIT approved and granted by (Superintendent of Highways) / Date
• Inspected By / Date
• Accepted By / Date

CONDITIONS AND RESPONSIBILITIES OF PERMITTEE

1. 1.The Town of Herkimer shall be held free from any manner of damages, claims, or demands of whatever nature which may arise as a result of granting of this permit or for any damage resulting from any faulty operation of this ditch crossing and/or its appurtenances.
2. 2.The applicant or contractor shall maintain and protect traffic by so conducting his construction operations that the traveling public is subjected to a minimum delay and hazard. Adequately lighted or reflectorized warning signs and barricades including red flags shall be furnished and erected to guide and protect the traffic until the work is completed. In addition, advance warning signs shall be set at about 300 feet each side of the work. The applicant or contractor shall provide watchmen and flagmen as may be necessary. All traffic protection shall be provided at the applicant's expense including any safety requirements as ordered by the Town Highway Superintendent.
3. 3.The work shall progress with as little delay as possible, and shall not be started until necessary materials and equipment are at the site.
4. 4.No trench cuts shall be closer than 2 feet from the pavement edge.
5. 5.Certain kinds of pipe are not allowed such as clay tile sheet metal, used boilers or tanks. Pipe allowed: corrugated metal, reinforced concrete, cast iron, smooth bore corrugated plastic.
6. 6.The surface of the driveway shall slope downward from the edge of the pavement not less than ½" per foot and not more than 1" per foot for normal shoulder width. Storm water from applicant's drive shall be conducted into the ditch (see sections).
7. 7.When a blacktop or concrete driveway is to be built, the shoulder shall be removed to a sufficient depth to provide a minimum of 6" of gravel or crushed stone base under the driveway paving and shall be properly flared at the pavement edge (see sections).
8. 8.No headwall or other obstruction shall be constructed to protrude above the lever of the shoulder. No part of any driveway shall be constructed outside of applicant's frontage.
9. 9.The highway must be kept in a clean condition at all times with no mud, stone, or other materials left on the pavement.
10. 10.The shoulder, ditch, guide posts, and back slopes, either side of this ditch crossing, shall be neatly restored to their original condition.
11. 11.Work must start within 30 days from date of permit.
12. 12.The Town of Herkimer does not assume any responsibility for clearance of snow or ice upon any portion of driveway or intersecting highway, even though some may be deposited by the Town in normal winter maintenance operations.
13. 13.The Town of Herkimer Highway Department reserves the right of inspection by authorized representatives of the Superintendent, of any driveway or intersecting highway construction within the right-of-way. In the event of faulty workmanship and/or materials, the Highway Department shall have the right to cancel the Permit until such time as those conditions are corrected. All costs, including removal costs by the Town forces, shall be borne by the applicant.
14. 14.No work shall be done to obstruct drainage or divert creeks, water courses, or sluices onto the right-of-way.
15. 15.Work locations must be approved by the Town Highway Superintendent or his representatives.
16. 16.The Town Highway Superintendent reserves the right to modify fees and to revoke or annul the permit at any time, without a hearing or necessity or showing cause.
17. 17.Only culverts of the diameter and lengths as specified on the front of this application will be accepted.
18. 18.The flow line of the culvert shall be the same depth as the roadside ditch flow line.

The original also includes two drawings, "Transverse Driveway Section" and "Driveway Profile Section", showing driveway width, slopes, pipe, bedding and backfill. Their small labels are not transcribed here; see the PDF.