Driveway Application

A minumum use driveway is a residential or other driveway which is expected to be used by not more than 25 vehicles per day (i.e. 50 A.D.T) See publication 312 guide.

Applicant/Property Owner:

Address:

Post Office:

Zip Code:

Phone Number:

Email:

County:

Municipality:

Driveway Diagram

In Relation to the Above Diagram, Which Direction Would Be North?

Posted Speed Limit (A)

Driveway Width (Must Be At Least 10 Feet For Cars)

Roadway Sight Distance (B)

Roadway Sight Distance (C)

Driveway Radius (D)

Driveway Radius (E)

Name Of Nearest Intersection

Distance To Nearest Intersection In Feet

Driveway Radius (Ft)

Driveway Width (Ft)

Route Number:

Date Work Scheduled To Begin

Date Work Scheduled To Be Completed

Application Is Made To

New Driveway

Existing Driveway

OtherOther

Is any portion of the property reserved for a person with a disability or a severely disabled veteran?

Yes

Under and subject to all the conditions, restrictions and regulations prescribed by the Pennsylvania Department of Transportation and on the issued Permit, Form M-945Pv

Signature

Clear

Full Name

Date

If you are human, leave this field blank.

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