TOWN OF BUXTON
Application for Entrance
David Pinkham, Public Works Director
185 Portland Rd
Buxton, Maine 04093
929-4400
Applicant Information Location Information
Name Map Lot
Address Road
Phone
*********************************************************************************
Location of Entrance ft. North, South, East, West (circle one) from ____
, for the following purpose:
Residential Commercial Development Other
1. Frontage of lot along highway ft.
2. Signage required (Paid by Applicant).
Type of sign (circle one below)
Stop sign $55.00
Road name $51.00 Paid by Check #________or Cash________
No Parking $28.00 Date paid______________ Initial_________
Dead End $44.00
3. Number of entrances requested .
4. Proposed width of entrance .
5. Culvert type .
6. Culvert size "diam., length .
7. Construction to commence on to be completed by
8. Contractor Name .
9. Speed Limit on road
10. Utility pole location .
Date Applicant Signature
Conditions of Approval
Certificate of Occupancy shall not be issued until final approval by CEO
Approved By
Road Commissioners Signature Date
Code Enforcement Officer Date Printed Name
ROAD SECTION/DRIVEWAY PROFILE
Please mark section that most closely resembles your situation.
PLOT PLAN
Sketch Driveway showing utility poles, mailboxes, any other obstacles on side of road
also note line of sight distance from curves, signs etc. that would obstruct view
Road Name
| 
