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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 AND RECONSTRUCTED DRIVEWAYS. Please submit to: Price County Highway Department; PO Box 169; Phillips, WI 54555. 

   PLEASE COMPLETE ENTIRE APPLICATION. "SUBMIT" BUTTON IS ON THE VERY BOTTOM.

   ONLINE PAYMENT IS REQUIRED. THE "SUBMIT" BUTTON WILL TAKE YOU TO PAYMENT PROCESSING.

   
   

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:


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

    This field is not part of the form submission.

91. Submit

* indicates a required field