Application for Driveway and Curb Cut Permit

APPLICATION FOR DRIVEWAY AND CURB CUT PERMIT

Property Owner’s Name:

Phone

Date Issued:

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Length of Opening:

Date of Opening:

Contractor Name:

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

**NOTE: A 2-INCH LIP MUST BE LEFT FOR DRAINAGE PURPOSES**

Signature of Applicant:

Date

Signature of Applicant:

Date

THE OPENING WILL BE INSPECTED BY BOROUGH PERSONNEL WHEN COMPLETED

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