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Peoria County Highway Department Entrance Permit

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This form has been modified since it was saved. Please review all fields before submitting.

Steps

1. Step 1 This section is complete This section is incomplete
2. Step 2 This section is complete This section is incomplete

Step 1

Type of Entrance*
Petitioner Information
First Name*
Last Name*
Petitioner Address*
City*
State*
Zip*
Petitioner Phone Number*
Include Area Code
Email Address
Continue

Step 2

Entrance Location Address
(If different from petitioner address.)
Address
City
State
Zip Code
Latitude (°N)
Longitude (°W)
Road Name*
Side of Road Entrance to be Placed On*
Culvert Length
(Feet - Leave Blank if Summit Entrance)
Culvert Diameter
(Inches - Minimum size is 15")
Installation Provided By:*
Material Type*
No plastic pipes are allowed.
Location Notes
Description or specifics of proposed location.
Plans, Drawings, or Sketches
Upload for electronic submittal if available.
Location Map
Upload for electronic submittal if available.
Contractor Information
(If Required)
Name
Email Address
Address
City
State
Zip Code
Phone Number
Fax Number
Acknowledgement of Conditions and Restrictions*
By checking "Yes", you acknowledge you have read and reviewed the Peoria County Highway Department Conditions and Restrictions for installation of Entrance Culverts.
1. Yes
Electronic Signature*
By checking "I Agree", you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.
1. I Agree