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TOWN OF CROSS PLAINS DRIVEWAY PERMIT APPLICATION <br /> DATE: !" ' 2.`3- ' ; <br /> I. CONTACT INFORMATION - To be Completed by Applicant: <br /> Name and current address %-e-R j t,.Y•rJ5-)r' <br /> of applicant <br /> .ti 2:434 tA) ":_,2...,F- o�.J ,i i s i c war. S' 3'i j <br /> Current telephone number: work ter? -Gss• 3•x`7 Z.,home u:oc3 - ,-;S s-- 7ac-,:f <br /> Driveway location in Cross Plains: / -;-- ?? ;TR6. .,_.0,,<..,. RQ%Co•- s <br /> Location:_west east south north side of Sec. <br /> Parcel number: 0-7 --7 laa - ,>1--1.--,-_--) -w; <br /> Contact Town Chairman,#798-0189,to arrange a site visit. <br /> Please attach a drawing of the driveway location discussed at the site visit and return to the Town <br /> of Cross Plains,3734 County Road P, Cross Plains, WI 53528, Phone (608)798-0189 <br /> as soon as possible after the site visit. <br /> II. CONDITIONS -To be completed by Town Board member or its agent: <br /> Width of driveway: feet Maximum grade of 12%. <br /> Drainage culvert needed: no X yes Tip go d <br /> If culvert required, must meet Driveway Construction Guide standards. <br /> Agricultural use only: 7 no ves <br /> Shared driveway agreement required: ? -no yes <br /> Other requirements: <br /> 1. Shall comply with town private road ordinance and driveway construction guide for new <br /> driveways. <br /> 2. Shall contact Town Patrolman before starting construction of the driveway. <br /> 3. No Town Building Permit or Dane County Zoning Permit shall be issued until Driveway <br /> Permit Part 1 AND Part 2 has been issued. <br /> -S4 <br /> 4. <br /> ***:x****************************************** ** ************* ****** <br /> III.APPROVAL— Date Approved By Town Board: I° .Vate Issued: I / I <br /> K <br /> The Driveway Permit is valid for one year from date of approval. <br /> The Driveway Permit is pending recordation of the Certifi Survey Map at Dane County j ed <br /> Register of Deeds <br /> Permit: Part 1 Driveway Permit Part 2 Single Residence <br /> S200.00 Fee V iU ) I rib° t M 1 35 -Y <br /> Reminder: Please check with Dane Co. Land and Water Resources Department on soil erosion <br /> permits to see if required. <br /> AP s A ( 4k)) .DR►V> /qc_ S <br /> 130 f-t,FRtSUNt_. F072. Tcw(3 Wa?,( A ,.D,/r C0C..VE&T.ilU C3pDx312. rt-) <br /> (3 0L l•O r A36 P c02rvl Er Pte_ Av4t. aGivicilE 77 S/s A R■ 35 A.. Do <br /> c-V7- uNnc- te'r-1WD P. o c Ern 2.wb si(6.7 a- <br /> -, PINS APPRnag) of coax-RT StZ W51}5F bR21Uc- <br /> _ L 0--A-- 1[S� k p4=5774-/A) OD .c CdtuSc,YLU CA <br /> �T�� , c /,4/i� <br />