ROAD CUT APPLICATION
APPLICANT
Name: Name.
Address: Enter Address, City, State, Zip
Phone: Phone.
Herein termed the applicant, requests permission to make a road cut across a county road.
LOCATION
Section: Section Township: Township Range: Range.
Exact distance and direction from a permanent landmark: Enter distance and directions from landmark.
Date:_________________ Approved by:_____________________________
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The Board of County Commissioners of Carbon County, Montana does hereby issue to
________________________________________ a permit to make a road cut across a county road, as located above. Work is to be completed immediately in accordance with plans and specifications furnished by the County Commissioners. Waterlines that are used all year must be buried a minimum of 6 feet. Construction must not interfere with road use. Permittee is responsible for public safety during construction; is liable for construction operations; must bury structure a minimum of 18 inches beneath the road surface (including ditch bottom and right-of-way); road cut fill must have a base of
4 inches ( minimum ) of 3/4 inch compacted, crushed gravel and a sub-base of 6 inches
( minimum ) of 3/4 inch minus compacted, crushed gravel; must return roadway to its former condition and reseed the right-of-way, as recommended by the County
Commissioners, if native sod is disturbed by construction; maintain settlement at the site for one year after construction; and keep the structure in repair.
Comments:______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
___________________________________
Carbon County Commissioner Fee: $100

1.
Give description of project and legal description.
2.
If there are existing metal culverts that will be replaced, it is understood that they will be reinstalled to provide proper drainage with proper cover.
3.
Backfilling of trench will be done in 6 inch layers. Each layer will be compacted. Trench will be filled and compacted to within 3 inches of surface of roadway and then trench will be filled with new 1 inch minus gravel, compacted and bladed to surface level of roadway.
4.
All signing and traffic control will be provided by contractor and/or landowner. All utilities will be notified and located prior to excavation.
5.
Carbon County assumes no responsibility for damage to roadway, utilities, personnel or property, during or after construction of irrigation pipeline.
6.
Landowners or utility companies will assume ALL responsibility for maintenance of excavated area for a period of one year.
_________________________________________
Landowner or Contractor
_________________________________________
Carbon County Commissioner