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Curb Cutting

  1. For Office Use Only

  2. (Street/Box Number & Name of Street)

  3. (FT)

  4. Principle Use of Property:

  5. Detail Existing Entrances (distances in feet)

  6. At Edge of Road

  7. At Property Line

  8. Within Town Way

  9. Culvert

  10. Sidewalk

  11. (Yes or No)

  12. Detail Proposed Entrances (distance in feet)

  13. At Edge of Road

  14. At Property Line

  15. Within Town Way

  16. Culvert

  17. Sidewalk

  18. Show proposed entrance locations, width and arrangement; distance between entrance; setback 9from edge of traveled way) of buildings, gasoline pumps, etc.; location of existing culverts, pipes, catch basins or manholes, curbing, gutter, and sidewalks; and the location of proposed culverts, ditches, curbing and sidewalks.

  19. Notice to Applicant

  20. 1. This form is an application only and no entrance work is to commence until the Entrance Permit has been ussed.

  21. 2. No excavation work is to commence until Dig Safe and all underground facility operators have been duly notified of the work 3 business days in advance in accordance with the current State of Maine statutory requirements.

  22. 3. All work must conform to the requirement of the Entrance Permit and the current copy of the "Rules & Regulations" as issued by the Town.

  23. 4. Fee

  24. Statement of Agreement

    I am duly authorized to execute this application and have reviewed and will comply with the above. I further agree to comply with all requirements of the Entrance Permit and agree to pay any subsequent charges which may become due as a result of my failure to comply with any of the permit requirements of the Right of Way Ordinance.

  25. For Office Use Only

  26. Leave This Blank:

  27. This field is not part of the form submission.