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�;� - � Dane County Department of Public Works, Highway and Transportation <br /> :f h 0 ACCESS PERMIT <br /> ,/' This permit is required and shall be issued in accordance with the provisions of Section 83.027 of the Wisconsin Statutes and Chapter 79 of the Dane <br /> / County Code of Ordinances. <br /> Name Co.Trunk Hwy in which access is requested: <br /> Jim Ellison JJ <br /> Street Address Town,Village,City Section <br /> 4671 CTH JJ Town of Vermont 2 <br /> City State Zip <br /> Black Earth WI 53513 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)767-3553 (608)767-3553 jim @quercus-LS.com <br /> Existing Access? If yes,how modified? <br /> Yes ❑ Relocated ❑ Removed © Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> Make joint res access and relocate existing shop access approx 150'east. <br /> North/South/EastiWest Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> North STH 78 1050 feet west Alex n Yes ❑ No <br /> Type of Permit Requested: <br /> ❑ $110 Temporary Controlled Access ❑ $75 Temporary Non-Controlled Access <br /> ❑ $110 Agricultural Controlled Access ❑ $75 Agricultural Non-Controlled Access <br /> ❑ $110 Residential(single family)Controlled Access ❑ $75 Residential(single family)Non-Controlled Access <br /> ❑ $220 Residential,Joint Access>1 parcel ❑ $220 Commercial,<100 ADT** <br /> ❑ $1,100 Private/Public, New/Existing,Street or Road ❑ $550 Commercial,>1000 and<1,000 ADT <br /> ❑ $45 Miscellaneous ❑ $1,100 Commercial,>1,000 ADT <br /> **ADT denotes Average Daily Traffic. Data substantiating ADT for access or road intersections may be required. <br /> Fees paid in full on 3/25/2014 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 14A007 <br /> The application submitted is hereby approved and this permit is issued by Dane County subject to full compliance by the Applicant with all provisions <br /> and conditions stated herein and on the reverse side hereof and all attachments hereto. <br /> Other Special Provisions: <br /> This permit is contingent on all other Local,State and/or County Agency permits,zoning and requirements. The existing <br /> driveway is to be removed and relocated approximately 150 feet to the east. An 18"(21"x15"equivalent)diameter culvert <br /> with approved metal apron endwalls is required at this location. Note: Culvert may be placed off R/W to match property <br /> drainage. <br /> Traffic control shall be as per the MUTCD. <br /> Check#2966 <br /> -----/ // <br /> By _1',/- 3/29/2014 <br /> �''ature of Dane ounty Repr 7 tative Date <br /> reggar Petersen Highway Engineer 608-266-9081 <br /> Name and Title Phone <br /> Page 1 of 2 <br />