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TOWN OF DUNN PARCEL #: 14-0610- 021 — ,9,06—Q <br /> . DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: <br /> SECTION 1-SITE VERIFICATION <br /> Applicant Name: ___3. (-- ;- f:"-ILL 4 '(2J rc.) Date: / ///l /' <br /> .'.?., <br /> .Address: 2 'I -Ita iJ_=4 )/a 14 . H4Li�.l))IJ WI Phone#: 212C- l'`17-1 <br /> Purpose: ® Residential ❑ Field Road Access ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: C c...,-1-1. :- LI k"-- L 4 . (2)/ __'`)/0 <br /> Proposed Driveway Location: I ' 7- - J.,e-, --/ I v.�z-'i -1 / !_ ,,,,.//`: '!I' i.v- <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# V.Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? ] yes ❑ no (If no, attach copy of easement.) <br /> Bldg Verification Date ." Comments= <br /> 1��� / — '- <br /> "�tl •.I�"�' ,"�...�.a '..�a�._.^�'�rtycfi`"�? e,ffk,.47i2L.t- -tt-r ;-( 1 c.:- <br /> SECTION 2 - SUBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Diagram Showing: Other: <br /> ❑ Property slopes. ❑ Copy of any required Dane Co. erosion control plan. <br /> ❑ Driveway slope. Other (_- } h r, 07 A_ AC,C. 1,-�L�. <br /> ❑ Driveway turnaround. U O__ _,-,\. - ," ) <br /> Ai0 Location&structure of retaining walls. <br /> ❑ Length,width&radius of driveway curves. <br /> ❑ Driveway cross section showing depth& fill material. <br /> Q Drainage culvert, :.�(/i ft. length, ;) in. diameter. 6,../ e, l(,)u. <br /> ❑ Driveway relationship to property lines, structures&roads. Center of driveway feet from <br /> The undersigned applicant as owner, or as owner's agent, does hereby attest that all the information provided is true and <br /> accurate and does liereby agree'to construct the described work in accordance with the plans and specifications filed. <br /> -, `� )/ L-----7--/_.-i / 1 / l I / <br /> ��~ ---�nature of Applicant Date <br /> Public Work f an lnitti`al Construction Approval DatePermit Issued Permit Feed <br /> fir K . i,::ter' .- y` v,/-4//-74,- $.. v <br /> SECTION 3 - FINAL APPROVAL <br /> ❑ The Town of Dunn has inspected the above field road and determination has been made that it meets <br /> 4Ilthe Town's minimum standards. The field road is authorized for agricultural use. <br /> ❑ The Town of Dunn has inspected the above driveway and determination has been made that the <br /> driveway meets the Town's minimum standards. The Dane County Zoning Office is hereby authorized <br /> to issue a building permit this day of , <br /> Signature of Public Works Foreman <br /> White - Town Yellow -Applicant Pink-Dane Co. Zoning <br />