Looking for a Idaho Legal Forms And Templates? Download it for free!

Permit No.______________________

APPLICATION AND PERMIT TO WORK WITHIN COUNTY RIGHT OF WAY

TETON COUNTY ROAD AND BRIDGE DEPARTMENT

Permittee __________________________________________Phone________________________________

Type or Print

Address

_______________________________________________________________________________

Street

PO Box

_______________________________________________________________________________

City

State

Zip

Road Name ____________________________________ Subdivision Name __________________________

Location (grid address must be correct) ________________________________________________________

Start Date ______________________________ Estimated Completion Date __________________________

Approach: ___Single residence

___ Subdivision

___Commercial

____ Agriculture

____Other

Type Of Work (Detailed Description)___________________________________________________________

_________________________________________________________________________________________

Excavation By _____________________________________________________________________________

Company Name

Contact

Phone

CULVERT REQUIRED: ___YES ___NO (To be determined by Teton County Road and Bridge Department)

CULVERT SIZE:___________________ (

Culvert size to be determined by the applicant, minimum culvert size is 18-inches)

If a culvert or bridge is installed over a canal, applicant must coordinate with the irrigation or canal company.

MAILBOX INSTALLATION: _____YES ____NO If a mailbox is installed at a location it must be on

a break away post at least 8' feet off the traveled roadway (in accordance with U.S. Postal regulations).

GENERAL REQUIREMENTS

A fee is required and due with the permit application. The fee is $30.00 per approach or for right of way work

for a single residence, and $60.00 per approach or for right of way work for a Subdivision or Commercial use.

The Local Highway Jurisdiction (LHJ) may change, amend or terminate this permit or any of the conditions herein

enumerated if permittee fails to comply with its provisions or requirements as set forth herein.

Approaches shall be for the bona fide purpose of securing access and not for the purpose of parking, conducting

business, or servicing vehicles on the public right-of-way.

No revisions or additions shall be made to an approach or it's appurtenances on the public right- of- way

without the written permission of the LHJ.

The permit tee shall furnish all material, labor and equipment involved in the construction of the approach and it's

appurtenances. This shall include furnishing approved drainage pipe of a size specified on permit.

The LHJ reserves the right to require the permittee, its successors and assigns, at any time, to make such

changes, additions, repairs and relocations to any approach or its appurtenances within the public right-of-

way as may be necessary to permit the relocation, reconstruction, widening, drainage, and maintenance of the

roadway and/or to provide proper protection to life and property on or adjacent to the roadway

Approaches shall conform to the plans made a part of this permit. Adequate drawings or sketches shall be

included showing the design, materials, construction requirements and proposed location of the approach. All

approaches shall be in accordance with Exhibits 9 and 13 of the Manual for Use of Public Right-of-Way Standard

Approach Policy.

Application And Permit To Work Within County Right Of Way Form - Teton County Road And Bridge Department

Related Articles

Related forms

Related Categories