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2. Application Date*
   Application Date

   Application Date
3. Resubmittal?*

   1. Yes
   2. No
5. PROJECT / SUBDIVISION NAME: *
7. APPLICANT EMAIL*
9. PROJECT ADDRESS OR LOCATION: *
11. COUNTY ROAD:*
12. COMMISSIONER PRECINCT:*
14. TYPE OF APPLICATION*

    1. DRIVEWAY
    2. SIDEWALK

    1. MAILBOX
    2. CULVERT

    1. OTHER
16. APPLICATION PURPOSE*

    1. RESIDENTIAL
    2. MANUFACTURED HOME RENTAL COMMUNITY

    1. COMMERCIAL

    1. OTHER (Please explain)
18. Other:
    If you chose "OTHER (Please explain)" above
20. FLOODPLAIN
22. IS ANY OF THE PROPERTY LOCATED IN A FLOODPLAIN OR FLOOD HAZARD AREA?*

    1. Yes
    2. No
24. Acknowledgment:
    The flood hazard boundary maps and other flood data used by Brazos County in evaluating flood hazards to proposed Developments are considered reasonable and accurate for regulatory purposes and are based on the best available scientific and engineering data On rare occasions greater floods can and will occur and flood heights may be increased by man-made or natural causes. Issuance of a Floodplain Permit in accordance with the Brazos County Flood Damage Prevention Ordinance does not imply that Development outside the areas of special flood hazard will be free from flooding or flood damage. Issuance of a permit shall not create liability on the part of Brazos County or any officer or employee of Brazos County in the event flooding or flood damage does occur.
26. TxDOT RIGHT-OF-WAY
28. WILL ANY CONSTRUCTION OCCUR IN TxDOT RIGHT-OF-WAYS? *

    1. Yes
    2. No
30. DIGITAL FILE SUBMISSION
32. COUNTY ENGINEER

    1. ADOBE (.pdf file) - (Email To: plats@brazoscountytx.gov)

    1. AutoCAD (.dwg file) - (Email To: plats@brazoscountytx.gov)
34. 911 ADDRESSING

    1. ADOBE (.pdf file) - (Email To: gis@brazoscountytx.gov)

    1. AutoCAD (.dwg file) - (Email To: gis@brazoscountytx.gov)
36. CONTACT INFORMATION
38. First Name*
39. Last Name*
41. Address1*
43. Address2
45. City*
46. State*
47. Zip*
49. Phone*
50. FAX
52. CALCULATIONS OF FEES (FOR CULVERTS ONLY)
54. NEW RESIDENTIAL
    $100
55. NEW COMMERCIAL
    $100
57. EXISTING RESIDENTIAL
    $50
58. EXISTING COMMERCIAL
    $50
60. RECEIPT BY BRAZOS COUNTY (Official Use Only)
62. DATE APPLICATION RECEIVED:
    DATE APPLICATION RECEIVED:

    DATE APPLICATION RECEIVED:
63. DATE APPLICATION RECEIVED / REJECTED:
    DATE APPLICATION RECEIVED / REJECTED:

    DATE APPLICATION RECEIVED / REJECTED:
65. County will assist as follows:
67. SIZE ONLY
    (Note: In subdivisions and on roads not maintained by Brazos County, the County will only size Culvert; the Owner will be responsible for installation)
71. CULVERT LOCATION (if the property is located in a subdivision, please provide the lot and block number; if not in a subdivision, provide approximate distance from the nearest intersecting road and whether the entrance is on the left or right side of the roadway): Culvert/Driveway location must be staked with T-posts or wooden posts at least 3-feet long with flagging at top of stakes and placed approximately 25-feet apart. County will determine/verify size of culvert.
73. The Commissioners Court of Brazos County, Texas hereby authorizes you (Applicant) to (re) construct facilities on the County right-of-way for Development of access to your property abutting
75. Located:
77. APPLICANT / PROPERTY OWNER CERTIFICATION:
    This permit shall not be valid until Applicant signs the statement in which he/she agrees to comply with conditions herein. I, the undersigned, hereby agree to accept and comply with the terms set out in this permit for construction of access driveway facilities on road right-of-way. Should the Applicant/property owner elect to install a driveway improvement within the right-ofway constructed of concrete pavement, brick or stone pavers, or other rigid material the Applicant/ property owner shall become solely responsible for the structure. Should removal of a portion or entire driveway or mailbox become necessary for any reason deemed by Brazos County, the cost of removal, and the cost for replacement, shall be the sole responsibility of the property owner. I certify that I have read the Brazos County regulations and agree to abide by them. I further acknowledge and agree that the obligations and duties contained herein shall be binding on Property Owners, heirs, successors, and assigns.
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79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit

* indicates a required field