TOWN OF LIVERMORE, MAINE

Application for Driveway Entrance

NOTICE: The town is responsible for maintaining only 1 driveway culvert/entrance per lot. If a 2nd entrance is requested, it requires approval from both the Highway Foreman and the Town Select Board.  It is the responsibility of the lot owner to ensure that any and all requirements listed on this permit are  met. It is also the responsibility of the landowner to ensure that driveways and culverts are installed  using proper methods and materials, and that they are constructed with drainage that directs water  away from public ways. The town reserves the right to inspect final work. Homeowners will be held  responsible for work not completed to required specifications.

Name:__________________________________________________ Date:________________________ Mailing Address:__________________________________________ Phone #:____________________

Location of proposed entrance, be specific and draw a sketch on the back.

_____________________________________________________________________________________ _____________________________________________________________________________________ Location of proposed entrance has been flagged? Yes_______ No_______

Tax Map Number: Map_____________ Lot_______________

Purpose for which entrance is requested:___________________________________________________ Estimated date of entrance construction:___________________________________________________

_____________________________________________________________________________________ Signature of Owner

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TOWN OF LIVERMORE, MAINE

DRIVEWAY ENTRANCE PERMIT

You are hereby granted permission to construct one/_______ entrance(s) at:

_____________________________________________________________________________________ Subject to the following:

Culvert size required: ___________________________________________________________________ Other requirements: ____________________________________________________________________ _____________________________________________________________________________________

_____________________________________________________________________________________ 10 Crash Rd Livermore, ME 04253 Phone:207-897-3207 Fax:207-897-9581