Town of Ulster | Driveway Application Permit

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Driveway Application/Permit

Applicant's Name *

Applicant's Phone *

Applicant's Email *

Owner's Name *

Owner's Phone *

Owner's Email *

Applicant's Address *

Owner's Address *

Location of work to be done *

Description of work to be done *

This form must have an illustration of the driveway plan attached (can be drawn by hand) and proposed driveway location must be staked out (marked with hardware or paint). Applicant must have a current Dig Safely New York ticket for the proposed plan.

DSNY Ticket # *

Driveway Plan Illustration *

Date of request *

Check all that apply *

Application is part of a sub-division on file

Applicant/owner is installing a first driveway

Applicant/owner is installing a second driveway

Applicant/owner is modifying an existing driveway

Applicant has submitted an illustration of the driveway plan. (Required)

Applicant has staked out proposed location of driveway. (Required)

Applicant's Signature *

Reset Signature

Signature is required.

Owner's Signature *

Reset Signature

Signature is required.

Captcha *

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FOR OFFICE USE ONLY

Date of Inspection:______/______/______

___ Town Road ___ State Road ___ County Road ___ Private Road

___ Approved ___ Denied ___ Not Applicable

The following requirements must be completed:

________________________________________

________________________________________

________________________________________

All above work has been completed and approved:

___ Yes ___ No

________________________________________     
Frank C. Petramale, Highway Superintendent

Date of Final Inspection

_____/_____/20____

PERMIT # _____________________________

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845-382-2765

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Driveway Application/Permit

FOR OFFICE USE ONLY