Driveway Permit

Open blank official PDF

Sign the printed copy, then deliver it with your check to the Engineer’s office at 1660 Island Road.

Property Owner (Applicant/Contact)

Current Address

City, State, Zip

Contact

Phone #

Property location

Township

Subdivision

Road Name

Located on the … side of road

North
East
South
West

Lot Number

Located between these addresses

and

Length of Property Frontage (feet)

Additional Information

Parcel ownership

Own the parcel which the proposed driveway is located on

If no, explain

Proposed driveway

Proposed Driveway (Single Residential Driveway, Farm Field Driveway, Commercial Driveway, Common Driveway, etc.)

By signing this application, the property owner agrees to construct or cause to be constructed the driveway or roadside pipe described above in accordance with the policies, procedures, requirements, specifications, and conditions of the Pickaway County Engineer at the approved driveway location. If compliance is not met in the opinion of the Pickaway County Engineer, it is understood that the County Engineer reserves the right to stop work being performed and restore the right-of-way to an acceptable condition at the expense of the applicant or other legal means as per ORC 5552.99. Once constructed the property owner is responsible for keeping the driveway or roadside pipe in proper repair and working order. Property owner is responsible for driveway repair, maintenance, and pipe replacement as required.

Property owner

Property Owner Signature (sign after printing)

Date

Call OUPS before you dig 1-800-362-2764

Make check payable to “Pickaway County Engineer”

Permit expires 90 days from driveway permit approval date

Driveway fee^* by class
Class	Fee
Class 5	$0
Class 4	$50
Class 3	$100
Class 2	$200
Class 1	$300
Underdrain Pipe	$0.30 per foot

* Reinspections caused by owner may result in additional fees.
* Culvert replacements, extensions complying with Pickaway County Driveway Standards, or other modifications as determined by the County Engineer, not involving land use change, will not be charged.

Driveway class descriptions

Class 5 driveway

field drive – provides access to agriculture lands and principally used by farm equipment
utility drive – provides access to public utility facilities

Class 4 driveway

farm drive – provides access to farm buildings, including single home
single family residence drive
single family common access drive serving two or more residences
multi-family residence drive serving five or fewer residential units
utility construction drive – provides access to construction of utility facilities
walking, jogging, biking or equestrian trails

Class 3 driveway

less than 100 trip ends in the peak hour

Class 2 driveway

100 or more but less than 200 trip ends in the peak hour

Class 1 driveway

200 or more trip ends in the peak hour

For office use only

Type of Road (Local Road, Minor Collector, Major Collector)

Fee Paid $

Receipt #

Initials

Date

Approvals

Preliminary Access Approval by

Date

Meets Access Management (Yes / No), Initials, Date

Permitted Driveway – Log Point, Width, Pipe Size and Location, Roadside Improvement Requirements

After construction

Post Construction Inspection Approval by

Date

New Address

Form revised 9/26

Nothing on this page is transmitted to the county. Print it, sign it, and deliver it as the form directs.