Application For Private Road Permit Form printable pdf download

APPLICATION FOR PRIVATE ROAD PERMIT

Please call and schedule an appointment with the Township Clerk, (734) 439-8842, in order to file a petition or application.

Parcel number where road is to be constructed: S-19-______-______-______

Owner/Applicant Name ______________________________________________________________

Address ___________________________________________________________________________

City, State, Zip ______________________________________________________________________

Phone # ____________________ Cell _____________________ Email _________________________

Proposed Road Name ________________________________________________________________

Proposed Number of Parcels to be serviced by the proposed road _____________________________

Type/Material of Private Road _________________________________________________________________

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I submit the following [fifteen (15) sets] of application with attachments, after having referenced York Township

Private Road Ordinance No. 143, York Township Zoning Ordinance, and York Township Fee Schedule.

Check Box if included. If not all boxes can be checked, the application will not be accepted.

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1. Engineering plans of the road, fifteen (15) Sets

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2. Road Maintenance Agreement, four (4) Sets

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3. Applicant to provide verification of proposed road name from the Saline or Milan Area Fire Department, and

the post office serving the proposed road – verify NO duplication of road name in zip code.

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4. Washtenaw County Road Commission approval for ingress/egress to County R.O.W.

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5. Washtenaw County Water Resources Commission (Drain) approval, if required.

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6. If applicant is not Property Owner, a signed and notarized letter from Owner(s) of Record must be provided.

YORK TOWNSHIP PRIVATE ROAD ORD NO. 143, SECTION 5. APPLICATION FOR ROAD PERMIT; REQUIREMENTS

Applications for private road permits shall be delivered to the Township Clerk and shall consist of the following information:

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A legal description of each lot to be served by the private road, a legal description of the private road

right of way, the name and address of all persons or parties having an interest in title to the lots and the private

road right of way area, and all easements that may encumber the site.

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A survey drawing prepared by, and bearing the seal of, a registered land surveyor or civil engineer

registered by the State of Michigan showing at a minimum all of the following:

An outline of the proposed road right of way including the dimensions and bearings thereof;

The existing spot grade elevations and topographic contours at two (2) foot intervals of the road right of

way area and all adjacent land within fifty (50) feet thereof, or within such greater area as may be

necessary to determine whether drainage methods will be adequate;

Soil characteristics and wet/wetland areas;

Landmark Trees identified in Section 50.31(G) of the Zoning Ordinance within the road right of way area

and all adjacent land within fifty (50) feet thereof;

Streams and all bodies of water within fifty (50) feet from the proposed road right of way area, or within

such greater area as may be necessary to determine whether drainage methods will be adequate;

Existing buildings within fifty (50) feet of the proposed road right of way area;

The proposed road right of way area in relation to the nearest property lines; and

The location of all proposed improvements in the road right of way area.

Application For Private Road Permit Form

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