APPLICATION/PERMIT for Access On or Work Within Highway Right-of-Way
Outagamie County Highway Department, 1313 Holland Road, Appleton, WI 54911-8947
• Use one form for each county trunk highway (CTH) access, change of existing access, or other activity within the County highway right-of-way. An access can be a driveway, public or private road, or a trail or trail crossing.
• The form initially serves as an application for access on or work activity within the right-of-way. Then if approved, the completed form becomes a permit for the access or activity.
• Send a completed application with original signature and appropriate application fee to: Outagamie County Highway Department, 1313 Holland Road, Appleton, WI 54911-8947.
• Just below the signature line, provide an area code and telephone number where you can be called between the hours of 8 a.m. and 4 p.m. Monday through Friday. Note if there are particular times of the day or days of the week that are more convenient to call you. If you have an e-mail address, provide that too. Outagamie County Highway Department may send you correspondence or your approved permit via e-mail in order to speed up the processing of your application.
• Fill out all required information. Processing may be delayed or a form returned if information is missing.
• If you have an existing permit for an access that you are planning to alter, relocate, or remove, provide the existing permit number or a copy of that permit.
SPECIFIC INSTRUCTIONS FOR EACH QUESTION
1. Applicant Name and Mailing Address: Provide the full name of the property owner or person requesting the permit. For a public road, this must be a unit of government. Also provide the street name and number and/or PO box number, city, state, and ZIP code. The address information is used to return the application/permit to the applicant.
2. Property Owner Name / Address (if not applicant): Provide the full name and address if applicable.
3. If Not Property Owner, Reason for Application? Permits are typically issued to property owner(s), but may be issued to prospective buyers or a company working on behalf of a land owner. For example, if you are not the current property owner but plan on purchasing the property, then provide a copy of the accepted “Offer to Purchase” document with your application.
4. Highway Letter: Provide the CTH letter that the access or work activity would be on.
5. Side of the Highway: Check the appropriate box for the side of the highway of the access or work location.
6. City – Village – Town: Check the appropriate box and provide the name.
7. Tax Parcel Number: Provide Tax Parcel Number from property deed or tax bill.
8. Name of Nearest Side Road from Location: Provide the full name of the nearest intersecting road to the connection.
9. Distance and Direction from the Side Road: Estimate the approximate distance (in feet or miles) by starting at the nearest side road and going along the CTH until you reach the center of the connection location. Select north, south, east or west (or N, S, E, W) for the direction.
10. Is this an Access Controlled Highway: This may be stated in your title documentation, Certified Survey Map, or an approved plat. Information regarding Outagamie County access controlled highways can be found at the following web address: http://www.outagamie.org/modules/showdocument.aspx?documentid=1316
11. Proposed Activity: Check only one of the five activity boxes:
• New Access: To construct a new access. This may include removal of existing access connections if required. If you are relocating an access check “change existing access”.
• Change Existing Access: To physically modify, or change the use* of an access connection where the location will not change. This includes work beyond routine maintenance such as paving a driveway, widening a connection, replacing a culvert, and improvements to the highway.
*Note: “Change the use”, means any modification to a property that results in a change in the number and/or types of vehicles using a property’s connection. Examples include changing from residential to commercial use, changing from single to multiple residential use, subdividing to accommodate additional residences or businesses, and changing the type of business.
• Miscellaneous Work in Right-of-Way: A permit is required for any other county highway right-of-way work that is not related to utilities, driveways, or road/street connections. Fill in Contractor Name. This work may include, but is not limited to:
• Storm sewers
• Drain pipes and drain tiles
• Ground monitoring wells
• Soil borings
• Pave Existing Driveway: To place pavement on an existing access.
• Parade or other special event: To hold an event that will require temporary occupation of county highway right-of-way. This includes closing to the public sidewalks, shoulders, or lanes of traffic for special event use.
12. Access Type: Check one box that best defines the requested access type and enclose appropriate payment along with the Application/Permit form. Public Streets and Trail Crossings require additional information. Contact the Highway Department for specific requirements.
13. Describe Proposed Work or Event: Provide a sketch in the box or attach a location map, engineering drawings, CSM, etc. For events, describe the event such as parade route or special event activity, and the requested time frame of right-of-way occupation.
14. Payment: Enclose the appropriate non-refundable permit application fee as indicated in Item 12 above. Application will not be processed until payment is received.
15. Staking: Place markers or stakes on each side of the work area that are visible from the road. These markers are required so that Highway Department staff can review the proposed location of an access or work activity.