Town of Peshtigo  ——— Address ——-Culvert and Driveway construction Permits

Owner: ____________________________  Mailing Address   ________________________________________

Phone: _______________________  email _________________________________________ Date ___________

Be aware that a new ordinance was enacted  December 1, 2022 by the town board (Ordinance 2022-01 )  that now requires  any new private road or any road construction to an existing town road,  street or highway shall be approved by the town board.  Sec 1  also specifies this applies to any new driveway or installing any new culvert or replacement of a culvert must be approved by town board. Upon getting your application I will review and provide a recommendation to approve or ask board to consider special circumstances.  If I get notification on board approval I will then issue the construction permit.  This process could take 30 to 60 days.


1. Proposed culvert material:           _____  concrete  ______PVC material approved for culvert applications  ____  metal

                Used culverts not allowed  without special approval.

2. Driveway length from principal structure or other main building to roadway.   _____ feet.

3. A 25 foot in length by 18 foot width segment will  be placed at each 200 feet of driveway length to provide passage of  meeting emergency vehicles.      ____ yes   ____  no   (Driveway is less than 200 feet to roadway)

4. Will a minimum 12 foot  wide driveway  be maintain to provide clearance for emergency vehicles for the full length?  

        ___yes   ____  no  (Provide details if answer is no.)  

5. Will a minimum height clearance of 18 feet be free of tree limbs and utility wires  and be maintained for length of driveway? 

       ___yes   ____  no (Provide details if answer is no.)  

6. Driveway width   ______ feet.    Plus at least 2 feet wider at each end than driveway  for total culvert length of ______ feet    

7. Culvert will  be placed at ditch line flow elevation with 2 to 5% slope. _____ yes   ____  no (If no provide details)

8. Backfill material will be at least 6 inches or culvert manufacturer recommendation. (Must support emergency vehicles.) ____ yes  ____ no

9. Proposed backfill material for this application.  ____ stone or gravel  _____   sand or topsoil   ____ clay 

10. Will driveway be paved?  ____No  ______ asphalt  _____ concrete

11. Will driveway apron in the road right of way be paved ? ____No  _____ asphalt  ____ cement

(Note that if cement it will not be replace by municipality if it needs to be removed for road or utility work. ) 

12. Driveway will be greater than 5 feet from a lot line.  ___yes   ____  no (Provide details if answer is no.)  

13. Will 2 foot culvert end walls be installed. ___yes   ____  no (Provide details if answer is no.)  

14. To your knowledge has water flooded over roadway at this location? __ yes ( Provide details ) ____No  ____Unknown

Provide information below and show on diagram with arrows where ….if any …..field or wetland flow ditches entering the road ditch that would add to the normal water flow through your proposed culvert from the nearest up stream or down stream from your proposed culvert . Your culvert must be at least as large as any upstream culvert plus size increase if additional flow requires a large size.


Requesting permit for a new driveway and placing new culvert in the roadway setback.   (yes )    (no)    Fee $75

Requesting permit to move or repair culvert in the roadway setback.     (yes )    (no)     Fee $75

Requesting approval for a new driveway in roadway setback using an existing culvert onto town road.    (yes )    (no)   Fee $75

Requesting only an address for an existing culvert onto town road.   (yes )    (no)   Fee $75

Requesting an emergency address number for a new culvert and drive way onto town road.   (yes )    (no)  Fee$150

Parcel number: _____________________________

Is this a shared driveway  (yes )    (no) 

(Note: Only three dwellings can share  same driveway.)


                           ——————————————flow line for ditch — [——————————]——————————————                                     

                                                                                                                                        (    Culvert located here   )

Use arrow to indicate north.

Use arrow to show water flow direction in ditch.

 Nearest address to right when facing property.


Nearest address to left when facing property.


   Exits on what road?     Driveway address if known.


Please place a flag or other clear marker on site to identify the center of where a new culvert will be located or to identify where an address is to be assigned if there are non addressed culverts between those identified above.

Send to:    Tom Smith Inspections LLC        2740 Otto Court     Green Bay   Wisconsin    54313