Driveway Access to County Highway Permit Request

2. Please use Internet Explorer or Mozilla Firefox when submitting a permit request.

4. PERMIT REQUEST FOR DRIVEWAY ACCESS TO COUNTY TRUNK HIGHWAY PRICE COUNTY HIGHWAY DEPARTMENT
   PLEASE NOTE THAT A $50 FEE NEEDS TO BE SUBMITTED FOR ALL NEW DRIVEWAYS (this fee is NOT required for driveway replacements). Please submit to: Price County Highway Department; PO Box 169; Phillips, WI 54555. Allow FOUR BUSINESS DAYS for processing your request.

   PLEASE NOTE THAT A $50 FEE NEEDS TO BE SUBMITTED FOR ALL NEW DRIVEWAYS (this fee is NOT required for driveway replacements). Please submit to: Price County Highway Department; PO Box 169; Phillips, WI 54555. Allow FOUR BUSINESS DAYS for processing your request.

6. First Name of Applicant*

7. Last Name of Applicant*

9. Address of Applicant*

11. City*

12. State

13. Zip

15. Applicant's Daytime Phone Number*

16. Applicant's Email Address

20. Name of Installing Contractor*

22. Address of Installing Contractor

24. City

25. State

26. Zip

28. Contractor's Daytime Phone Number*

32. Town, City or Village of:*

33. County Highway*

34. Side of Highway*
    -- Select One --EastWestNorthSouth

36. Intersection*

    Name of closest crossroad

37. Direction from Intersection*
    -- Select One --EastWestNorthSouth

38. Feet from Intersection*

40. NOTE: Driveway location must be marked in field so that it can be inspected. To eliminate delays, please mark the location before you submit your permit request.

42. Legal Description of Property Served

44. Tax Parcel No.*

45. Quardrant*

    NW, NW 1/4, etc.

47. Section*

48. Township*

49. Range*

53. Proposed Driveway Width:*

    Feet

54. Driveway Material:*
    -- Select One --GravelEarthAsphaltConcrete

    Choose one

56. Is Driveway New or Replacement?

    1. New
    2. Replacement

57. Is Driveway Permanent or Temporary?*

    1. Permanent
    2. Temporary

58. If temporary, date driveway will be removed:

60. Proposed date construction to begin:*

61. Driveway Intended Use:*
    -- Select One --PedestrianBusinessAgriculturalResidentialRecreational/CabinRecreational/LandLogging

    Choose One

63. Is the driveway close to a hill, valley or horizontal curve that restricts sight distance:

    1. Yes
    2. No

64. If yes, please refer to the chart below. A driveway must meet the minimum stopping sight distance shown in the chart or it will not be approved.

66. Design Speed (MPH)

    1. 25
    2. 30
    3. 35
    4. 40
    5. 45
    6. 50
    7. 55
    8. 60
    9. 65
    10. 70

67. Stopping Sight Distance**

    1. 155
    2. 200
    3. 250
    4. 305
    5. 360
    6. 425
    7. 495
    8. 570
    9. 645
    10. 730

68. **For the speed shown, there must be unimpeded vision from the driveway for the distance shown. This is for both horizontal curves and hills or valleys. The distances shown are minimums and larger distances are preferred.

72. Other Information

74. Signature of Applicant*

75. Date*
    Date

79. Attach a map or sketch showing the location of your driveway.

81. Map/Sketch

85. Price County Highway Department, PO Box 169, Phillips WI 54555

87. Phone: 715-339-3081 Fax 715-339-2381 www.co.price.wi.us

Leave This Blank:


88. 1. Receive an email copy of this form.
89. Email address

    This field is not part of the form submission.

90. Submit Submit and Print

* indicates a required field