TOWN OF YORK

                                    DRIVEWAY/ACCESS VERIFICATION CERTIFICATION

                                                GREEN COUNTY, WISCONSIN

(This application for a Driveway Permit must be submitted to the Town of York Board of Supervisors according to the Driveway Permit Ordinance standards.  The completed application must also be submitted, with required attachments, with the Zoning Permit application to Green County Zoning, N3150 Highway 81, Monroe, WI 53566.  (608-328-9423) Pursuant to Green County Code Section 4-6-1-2:a.6, this form is required to be completed and submitted to the Green County Zoning Department at the time of application for a Zoning or Land Use Permit for projects requiring new or altered use of an access driveway for the premises.  The purpose of this form is to certify that the Town has issued a Driveway Permit.  Signature(s) on this form must be dated within 60 days of the date of application.  Required attachments for some driveways must also be submitted with this form (see below).

  Name of Applicant ___________________________________________________

  Current address: _____________________________________ Phone: _________

  Project: _____ Construction of: _________________________________________

               _____ Other land use: __________________________________________

  Location of proposed driveway/access:

  Section: _____ Town of York, Lot # _____  CSM # _________

  Name of public road to serve as access to the premises: ______________________

  Side (direction) of public road: ____________________________

  ______ feet (circle one) north  east  south  west    of _________________________(road)

Other information: ____________________________________________________

  I certify that the application of Town of York driveway standards and ordinances have been applied to this project and have been agreed to by the Town and the applicant to the extent that the applicant may proceed with an application for a Zoning Permit/Building Permit for the above project at the above location:

  Signature of Town Official:  _______________________________________________________

  Date: _______________________   Title: ___________________________________________

  IN ADDITION: If access is by County Trunk Highway, a completed County Highway Department Driveway/Access Permit Form must be attached.  If access is by a State Trunk Highway, a completed Wisconsin Department of Transportation Driveway/Access Permit Form must be attached.

            ALSO ATTACH: Erosion control plan; Engineer’s Plan (if required); Maintenance Plan

                                                (for joint/shared private driveway)

  _____ This driveway is off a private roadway.  (check if applicable)

  Maintenance of private roads is not the responsibility of the Town of York.

For a printable pdf file of application and ordinance (requires Acrobat reader) Click Here

Download Acrobat reader  

To have a driveway packet e-mailed to you as a WORD file, use the following link:

 emailfile@townofyork.org 

To request a paper copy sent to you by US mail, use the following e-mail link:

application@townofyork.org

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