v. 10/30/17 1
Driveway/Temporary Access Application
Mailing Address________________________________________________________
Telephone #_______________________ Date_______________________
Location of Driveway____________________________________________________
Map______ Lot________ Contractor ___________________________________
A permit is required to be approved by the Director of Public Works, or designee, before any
construction of the access may begin. The proposed location must be pre-marked prior to inspection and
approval of the Driveway Permit, in accordance with the Town of Amherst Driveway Permit
Regulations. This permit is valid for a period of one (1) year from the date of issuance. Application may
be made for a one (1) year extension, such request to be submitted prior to the expiration of the permit.
Any modification of roadway facilities, including curbing or sidewalk, will require a Street
Occupancy/Road opening permit in addition to the driveway permit. Temporary access points may be
converted into permanent driveways, provided other requirements are met, and the access in located in
the approved location.
Preliminary inspection: Shall be completed by the Director of Public Works or his Designee, within
five days of date of application submittal.
Bond and Fee: Applicants for a Driveway Permit shall submit a $50.00 application fee and a security as
defined in Section 3.10 (J) of the Amherst Roadway and Utility Standards until such time as a
Certificate of Completion has been issued or (two separate checks made payable to the “Town of
Amherst” are required, one for the permit and one for the security).
Final Inspection: Upon such determination by the Director of Public Works, or designee, the security
bond may be returned to the applicant. However, if the access is determined to be improperly
constructed and poses a liability to the town, the bond will not be returned and the town may take
additional steps towards recovering any additional costs incurred to protect all roadways.
Scenic Road ( ) yes ( ) no Layout plan included ( ) yes ( ) no
For Temporary Access Points only:
Temporary Access Point to be utilized (dates) from: ________ to: ________
Reason/Proposed Use of Temporary Access Point: _______________________________________
v. 10/30/17 2
As the landowner (or designated applicant) I agree to the following:
1. To construct access point(s) only for the bonafide purpose of securing access to private property
such that the right-of-way is used for no purpose other than travel.
2. To construct access point(s) at permitted location(s).
3. To construct access point(s) in accordance with ordinances and permit specifications as issued by
the Town of Amherst.
4. To defend, indemnify and hold harmless the Town of Amherst and it’s duly appointed agents and
employees against any action for personal injury and/or property damage sustained by reason of
the exercise of this permit.
5. To furnish and install construction entrance/exits as necessary and drainage as necessary to
provide proper and suitable discharge or soils, debris and surface drainage in and around the
entrance from the Town right-of-way to the temporary access point.
6. I am the owner or a duly authorized agent of the owner of the parcel upon which the driveway
will be constructed. I understand that the Department is relying on this information in
considering this application and that the Department does not perform independent title research
or make judgments about title or access disputes.
Owner’s Signature _______________________________________________________
(For Internal Use Only)
Bond Amount: ____________ Security Paid By:_______________________________________
Pre-construction inspection date: _____________________ Approved ( ) Yes ( ) No
Approved or Rejected application sent to Community Development Office, date _______________
Inspector’s Signature_______________________________________________________________
Recommendations by Inspector_______________________________________________________
Final Inspection by______________________ Date_____________________________________
Date Security returned______________________
click to sign
click to edit