RCW ACCESS PERMIT / SITE GRADING INSTRUCTION SHEET



TOWN OF CALEDONIA

ROW ACCESS PERMIT/

SITE GRADING INSTRUCTION SHEET

PARCEL 004-04-      |For Town Use | | |

| |Permit Number: |      |

| |Receipt Number: |      |

| |Account Number: |      |

| |Approved / Denied | |

| |Date Issued: |      |

| |

|Name of Applicant: |      |

|Phone Number: |      | |      |

| |(Work) | |(Home) |

|Address of Applicant: |      |

|Owner: |      |

|Phone Number: |      | |      |

| |(Work) | |(Home) |

|Highway Access Permit Fee - $100.00 |

|Payment Rcvd.: |      | |      | |      |

| |Date | |By | |Rec. # |

|Culvert Required: | Yes No |Culvert Length (min.): |      |

| |(Feet) |

|Culvert Diameter and Type: |      |

|Culvert Elevation (Flow Line): |      | North West |

| |(Feet) | |

|Culvert Elevation (Flow Line): |      | South East |

| |(Feet) | |

|Note: Flared end Sections will be required on all driveway culverts unless waived in writing by Town Engineer. Culvert must be installed and |

|driveway built before construction begins, unless temporarily waived in writing by Town Engineer. |

|Remarks: |      |

| |      |

| |      |

| |

|Signature of Applicant: | |Date: |      |

| |

|Permit Granted: |      |Date: |      |

| |Town Engineer | | |

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SITE GRADING AND FINISHED YARD GRADE INSTRUCTIONS

|Proposed Finished Yard Elevation: |      |

|      |

|      |

|Note: The finished yard elevation shall be the finished elevation around the immediate perimeter of the building. The contractor shall be |

|responsible to calculate the depth of footing excavation which will provide for the above assigned finished yard elevation. |

| |

|Approval: |      |Date: |      |

| |Town Engineer | | |

|Remarks: |      |

| |      |

| |      |

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