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TION OF ROAD MAINTENANCE CLASSIFICATION <br />BUJ I $ 2001 ~'i ~1~ MOFFAT COUNTY ROAD DEPART~AENT <br />TfiTs foam must tie approved and attadred to the Molter Courrty Road Departrnent FZigM~WaY Aocess <br />Pennic Application prior to corrsderation of approval of access corlstrtrdion. <br />APPUCIwr <br />a This access location ~ located on a year-norard marrt~ined county -oad. This does not <br />guararrgee-thatthe courrty mad aera3satrtg tite access locatiort is maintained on a <br />regu~r basis or that snow is plowed on the same day it ocwrs. <br />Date: <br />Land Owner or Legal Representative Stignatum <br />a 1 IRlder'atdlld this access lOCabOn is On a °NO YIIINTEJ2 MAIN fE1W4NCEs Section Of <br />County road. Moffat CO1°~ wtii not mairtlaet or pbw this section of road from <br />appro>mt~ely Novan6er 1 through June 1° or {aver depend'mg upon condeions. The <br />Cowrty does not allow prirage indvidtmis to plow ar nrain~et Courtly roams witlwut a <br />permk. 1 understand artd agree that no wlrtter rneirrterrance of tills road may affect my <br />use of mY P~wY durfiig wringer nwrttlts. <br />Date: <br />Land Owner or Legal Representative Signature <br />© Before cortstrtrction begets, applicant must receive aRight-of-INay Aces Permit from <br />the Moi'Fat Courtly Road Departrnertt Permits are not always grained due to conditions <br />~ specific loratirnts (te_ brrrM curves, steep grades, ere.}. You must Cortfact the Road <br />Oeparirtterrt and obtain your access permit before beginrNng carstruction. Applicant <br />understands that no firtai ittspectiort of the construction sips will occur or certificate of <br />occupancy issued until the lemrs and eortditiorrs of the R'igM-of~Nay Access Pemtit <br />Imve beemcompleged. <br />< < ~~1 ra~~ Date: '%. ~ ~ -7 <br />Land Owner Legal Representative Signature <br />CHECK APPROPRIATE BOX AND SIC;g1: <br />