Driveway or Access Road Permit
Town of Clover
Driveway or Access Road Permit for Ordinance #20170510-1, Road, Driveway and Right-of-Way Ordinance as Amended 20201111-2
Please print this form and return it with your check payable to the Town of Clover to:
Tracy Gillespey, Clerk, Town of Clover, P.O. Box 94, Herbster, WI 54844
To be Completed by Town employee, Town of Clover Emergency Services Officer-as indicated-and Town Chair: (Check if met)
- Provides direct ingress or egress [S4.A.1.]: 󠄁󠄀
- Provides a minimum of 150 feet of sight distance [S4.A.1.]: 󠄁󠄁
- Located, as possible, so as not to interfere with existing utilities [S4.A.1.]: 󠄁󠄀
- Driveway length greater than 100’ from road to principal structure [S4.A.2.]: 󠄀󠄁
- If length greater than 100’ from road to principal structure, appropriate member of emergency services assessed for proper ingress and egress [S4.A.2.]: 󠄁󠄀 Initials:______
- Intersection with roadway sloped to preclude ordinary surface water drainage onto roadbed [S4.A.3.]: 󠄀󠄁
- Driveway apron does not extend into the road further than roadway or pavement edge [S4.A.3.]: 󠄀󠄀
- No entrances, ditches or roadside areas or existing structures in right-of-way [S4.A.3.]: 󠄁󠄁
- Driveway and parking areas graded so no storm water discharges onto roadway [S4.A.3.]: 󠄁󠄀
- If relocation of utilities required, has the Town Board approved relocation or alteration? [S4.A.4.]: 󠄁󠄁
- If any of above not met, did Town Board approve variance? [S4.A.5.]: 󠄁󠄀
- If Field Road, Agricultural, Commercial or Industrial Driveway:
- Angle between centerline of driveway and edge of surface of public roadway not less than 70 degrees [S4.B.1.a.]: 󠄀󠄁
- If industrial road, meets requirements of S4.B.1.b.: 󠄀󠄀
- Special Requirements for Residential Driveways:
- No less than 24’ wide at edge of roadway surface [S4.B.2.a.]: 󠄀󠄁
- Minimum width of driving surface no less than 14’ [S4.B.2.a.]: 󠄁󠄀
- Minimum height clearance of 14’ [S4.b.2.a.]: 󠄀󠄁
- Unobstructed turnaround sufficient to accommodate emergency services vehicles and Town vehicles (grader, dump truck) [S4.B.2.b.]: 󠄀󠄀
- Angle between centerline of driveway and edge of surface of public roadway not less than 70 degrees [S4.B.2.c.]: 󠄀󠄁
- Culvert Construction Standards:
- Installed prior to beginning construction on property [S4.B.3.a.]: 󠄀󠄀
- Galvanized steel or HDPE? [S4.B.3.a.]: 󠄀󠄁
- Provides adequate bearing capacity for all vehicles expected to use driveway [S4.B.3.a.]: 󠄀󠄀
- Minimum size 24’ length & 12” diameter but final specifications to be determined by Town Crew and Town Chairperson [S4.B.3.b.]: 󠄀󠄁
- Final Specs for culvert in question: [S4.B.3.b.]
Length _______feet, Diameter ________inches
- Placed in ditch line as marked by Town Board as recommended by Town Crew [S4.B.3.c.]: 󠄁󠄀
- No end walls or abutments of timber, rock or similar material [S4.B.3.d.]: 󠄁󠄁
- Material compatible with culvert selection [S4.B.3.e.]: 󠄀󠄀
- At least 6” of cover measured from top of culvert [S4.B.3.e.]: 󠄁󠄁
Property Owner agrees to the above conditions:
____________________________________________ ____________________
Signature (Property Owner) Date
Authorization to Install Culvert and Construct Driveway:
____________________________________________ ____________________
Signature (Town Chairperson) Date
Date of Compliance Inspection: _________________
Inspected by: _____________________________
__________________________________________ ____________________
Signature (Town Chairperson) Date
___________________________________________ ____________________
Signature (Town Clerk) Date
Created: 10/14/09 TC/Ordinances/Form Permit Driveway
Revised: 9/14/16;1/24/17;5/11/17;8/6/19; 9/1/20;11/9/20