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e5]O1a15 SYSTEMS PLANNING 0403 Papa3d3 If you are requesting commercial or industrial access, please indicate the types and number of businesses and provide the boor area square ' footage of each. Use additional sheets if necessary, Business (Nems and Type) Square Footage Srntness (Nance and Type) F 1 . Square Foote e if you are requesting a residential development access, what is the type (single (amity, apartment, townhouse) and number of units? Type Number of Units Provide an estimate of the daily traffic volume anticipated for the entire property at build out. (An individual single family Fume, duplex, pr quad•plex Is not required to complete this section). Daily Traffic Estimate = (Use the latest Institute of Transportation Engineers UTE) Trip Generation Reports Ifyou used the ITE Trip Generation Report, provide the land use code, independent variable, and reference page number, LandUse Code n epen 1 111 ent enable - ~ eportpagenum erre rents Check with the Florida DOT Ofice where you will return this form to determine which of the following documents are reouired to complete the review of vour application. Plans should be 11" x 17" (s( ale 1" x 50') Note: No plans larger than 2d" x 36" will bA accepted 0 Proposed access design a) Highway and driveway plan profile 9) Parcel and ownership maps including easements (Boundary Survey) r b) Drainage plan showing impact to the highway right-of-way h) Signing and striping plans c) Map and letters detailing utility locations before and 0 Trete ControWaintenance of Traffic plan after Development in and along the right of way D Proof of liability insurance d) Subdivision, zoning, or development plans k) Traffic Impact Study e) Property map indicating other access, bordering roads and streets 1) Cross section of roadway every 1 DO' if exclusive tum lanes are I re ulred Important Notices to Applicant Before Signing Application The Department Reserves The Right To Change Traffic Features And Devices in Right Of Way At Any Time (- Proposed traffic control features and devices in the right of way, such as median openings and othertraffic control devices, are not part f the connection(s) to be authorized by a connection permit The Department reserves the right to change these features and devices in theo future in order to promote safety in the right of way or efficient traffic operations on the highway. Expenditure by the applicant of monies for installation or maintenance of such features or devices shall not create any interest in the maintenance of such features or devices. S Significant Changes In Property Use Must Undergo Fu rther Review If an access permit is issued to you it will state the terms and conditions for its usa. Significant changes in the use as defined in Section 335.182(9)3 Florida Statutes, of the permitted access not consistent with the terms and conditions listed on the permit may be considered a violation of the permit. i All information I Give It Accurate I certify that I am famillarwith the information contained in this application and that to the b information is true, complete and accurate. est of my knowledge and belief, such 1 i L Starting Work On The Driveway Connection After I Get My Permit Means I Accept All the Conditions in My Permit 1 will not begin work on-theconnectionuntil l receive my Permit and I understand-all-the conditions o, the Permit. the connection, I am accepting all condition listed In my Permit rdtren I begin work on Applicant Name (Prin d): Applicants signatu Date j 3_ r i Will ® s z�apopt a m §,;I At 0 ��t2sae® azo i