OFFICE USE ONLY

COMMERCIAL ACCESS PERMIT APPLICATION Township

CALHOUN COUNTY ROAD COMMISSION Permit Number
13300 15 Mile Road - Marshall, MI 49068
Date Issued
Phone (269) 781-9841 (800) 781-5512 - Fax (269) 781-6101
www.calhouncrc.net Expiration Date

APPLICANT: OWNER DEVELOPER OTHER CONTRACTOR:

NAME: NAME:

ADDRESS: ADDRESS:

CITY: STATE: ZIP: CITY: STATE: ZIP:

PHONE: FAX: PHONE: FAX:

EMAIL ADDRESS: EMAIL ADDRESS:

Applicant agrees to and will adhere to the conditions stipulated on this application, as well as, all specifications listed on
the permit when issued. Issuance of this permit does not imply consent for use of the land that may be inconsistent with
other local, township, county, state and/or federal ordinances and does not negate the need for other such permits.
This permit is good for one year from issue date or otherwise stipulated on permit when issued.

Applicant / Contractor Signature Date

Location

Street Number (if known) Street Name on the side.

(N, S, E or W)

Located of Township
(Feet or Miles) (N, S, E or W) (Closest Intersection)
Please check the appropriate category:
Commercial Access New Drive up to 8 Parking Spaces $107.10 _____
Commercial Access New Drive 9 to 20 Parking Spaces $226.80 _____
Commercial Access New Drive 21 to 50 Parking Spaces $258.30 _____
Commercial Access New Drive 51 + Parking Spaces $378.00 _____
Commercial Access Recap existing driveway $ 63.00 _____
Commercial Access Detail Review $ 81.90 _____
Temporary Construction Access $ 63.00 _____
Standard Specification Book (printed) $ 37.80 _____
Standard Specification Book (CD) $ 37.80 _____
Other: _______________________________ $ _____ _____
Staking of Proposed Access
Stakes three and one half (3 ½) feet above the ground with a noticeable color tip or flagging must be placed on each side of the
proposed access and at either property line for the purpose of determining sight distance. These stakes should be in place when the
access is applied for. Project plans conforming to the Calhoun County Standard Specification Book are also required.
Special Instructions:
1. Access must slope away from the road ½ inch per foot, a minimum of four (4) feet or the width of existing
shoulder, whichever is greater.
2. CCRC policy requires culvert installation for driveways/roads countywide.
3. Applicant will provide a detailed drawing of the site showing proposed access(es).
4. Thoroughly read the back of this application. The permit is good for one year from the permit issue date.
Approved by Title Date
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1. Specifications. All work performed under the permit must be done in accordance with the plans, specifications, maps and statements filed with
CCRC* and must comply with CCRC’s current requirements and specifications on file at its offices and / or M.D.O.T. specifications. This
permit is valid for one year from the "Approved by" signature date or as otherwise stipulated on permit when issued. Any driveway that is not
created or hard surfaced within this time frame, must have an additional permit in order for further work to be executed.

2. Standard Specifications. The Calhoun County Road Commission requires anyone who is applying for a commercial/private road permit to
purchase or have purchased a copy of our current Standard Specifications Book. Applicant agrees that all commercial/private road permits will
abide by the CCRC current standard specifications.

3. Fees and Costs. Permit Holder shall be responsible for all fees incurred by CCRC in connection with this permit and shall deposit estimated
fees and costs as determined by CCRC at the time the permit is issued.

4. Insurance. Permit Holder shall furnish a certificate of liability and property damage insurance showing that coverage is in effect for the
person/organization that will be shaping the access. This certificate of insurance will show coverage of a minimum of $500,000 as required by
CCRC. The certificate of insurance must contain the following language: “Additional insured with regard to Liability Coverage: Calhoun
County Road Commission, Board of County Road Commissioners, its officers, agents, and employees, 13300 15 Mile Road, Marshall, MI
49068”. Such insurance shall cover a period not less than the term of this permit and shall provide that it cannot be canceled without ten (10)
days advance written notice by certified mail with return receipt required to CCRC.

5. Indemnification. Permit Holder shall hold harmless and indemnify and keep indemnified CCRC, its officers and employees from all claims,
suits and judgments to which CCRC, its officers, or employees may be subject and for all costs and actual attorney fees which may be incurred
on account of injury to persons or damage to property, including negligence of the Permit Holder and CCRC arising out of the work under this
permit, or in connection with work not authorized by this permit, or resulting from failure to comply with the terms of this permit, or arising out
of the continued existence of the work product which is the subject of this permit.

6. Miss Dig. The Permit Holder must comply with the requirements of Act 53 of Public Acts of 1974, as amended. CALL MISS DIG AT (800)-
482-7171 AT LEAST THREE (3) FULL WORKING DAYS, BUT NOT MORE THAN TWENTY-ONE (21) CALENDAR DAYS, BEFORE
YOU START WORK. Permit Holder assumes all responsibility for damage to or interruption of underground utilities.

7. Time Limit. All work under this permit must be done within one (1) year or as otherwise stipulated on the permit when issued.

8. Safety. Permit Holder agrees to work under this permit in a safe manner and to keep the area affected by this permit in a safe condition until the
work is completed. All work site conditions shall comply with Michigan Manual of Uniform Traffic Control Devices.

9. Restoration and Repair of Road. Permit Holder agrees to restore the road and right-of-way to a condition equal to or better than its condition
before the work began; and to repair any damage to the road right-of-way that is the result of the facility whenever it occurs or appears.

10. Limitation of Permit. This permit does not relieve Permit Holder from meeting other applicable laws and regulations of other agencies.
Permit Holder is responsible for obtaining additional permits or releases which may be required in connection with this work from other
governmental agencies, public utilities, corporations and individuals, including property owners. Permission may be required from the
adjoining property owners.

11. Revocation of Permit. This permit may be suspended or revoked at will, and the Permit Holder shall surrender this permit and alter, relocate or
remove its facilities at its expense at the request of CCRC.

12. Violation of Permit. This permit shall become immediately null and void if Permit Holder violates the terms of the permit, and CCRC may
require immediate removal of Permit Holder’s facilities, or CCRC may remove them without notice at Permit Holder’s expense.

13. Assignability. This permit may not be assigned without the prior approval of CCRC. If approval is granted, the assignor shall remain liable
and the assignee shall be bound by all the terms of this permit.

14. Further Requirements. This permit is subject to supplemental specifications on file with CCRC and Act 200 of Public Acts of 1969.

*Calhoun County Road Commission

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