117 NW Lafayette Avenue, Bend, Oregon 97703 | P.O. Box 6005, Bend, OR 97708-6005
(541) 388-6575
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SharePoint: Driveway Access Permit
4/4/19
COMMUNITY DEVELOPMENT
ACCESS DRIVEWAY PERMIT APPLICATION
(Connections to public roads or rights-of-way only)
INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
Date: ________________________ Access Permit Number:
Land Use File Number (if applicable):
Permit Address:
Property Description: Township: ________ Range: ________ Section: ________ Tax Lot: ________
Nearest Intersection:
Applicant’s Name:
Mailing Address (if different):
City / State / Zip:
Phone: (_____) _______________
Applicant’s Email Address:
Type of Access (check one): □ Residential □ Commercial □ Farm
Surface Type (check one): □ Concrete □ Aggregate or Cinder Base □ Asphalt
Other:
Applicant hereby applies to Deschutes County for permission to construct a driveway access at the permit address
above. All work shall be in conformance with Deschutes County Code 17.48.210, 17.48.220 and 12.28. The driveway access shall
be maintained as approved and shall not present a traffic hazard for road or driveway users.
Applicant agrees and understands that this permit does not constitute a land use permit. Any development of property
connected with this permit must comply with all applicable land use regulations.
Please include a drawing or site plan sketch (space provided on the back of this form), showing the location and type
of access. It should indicate the driveway’s position relative to landmarks such as roads, other driveways, fence lines, power
poles, etc. Please include a north arrow, and mark the proposed access in the field at the road with stakes, flags or paint on the
road so the inspector can readily locate it. For properties within unincorporated communities, please indicate whether a curb
cut and/or sidewalks will be required. If required, public sidewalks shall be constructed at the time the driveway access is
constructed. Note: If a curb cut is required for the installation of the driveway, a permit to work in the public right-of-way is
required from the County Road Department.
Disclaimer: Deschutes County will not take responsibility for ensuring that all other conditions of any other regulating
agency have been complied with. It is the responsibility of the homeowner to meet any existing subdivision covenants,
conditions and restrictions, and all other neighborhood and regulatory agency requirements. Applicant/Owner agrees to
remove any construction elements not meeting standards, as determined by Deschutes County.
Applicant’s Signature: Date:
Clear Form
Area Drawing Showing Subject Property
(A map may also be attached)
Office Use Only
Special Conditions:
Distance to Nearest Intersection: ________________________________ Mile Point:
Road Name: _____________________________________Road Number:
Approved by: DESCHUTES COUNTY ROAD DEPARTMENT
Printed Name:
Date:
DESCHUTES COUNTY COMMUNITY DEVELOPMENT DEPARTMENT - PLANNING
Printed Name:
Date:
