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TOWN OF ALBION <br /> ACCESS "DRIVEWAY"APPLICATION AND PERMIT. <br /> FROM PRIVATE PROPERTY TO A TOWN ROAD <br /> Cost of Access Permit is $25.00 Deposit: $1000.00 <br /> Name of Applicant Matson Custom Homes, Inc. / Dr. Jason Gurien <br /> Street Address: P.O. Box 333 <br /> City, State, Zip: Stoughton, WI 53589 Phone: 608-873-0500 <br /> (o9S- ��cZ <br /> Property Owner Name (if different from Applicant) Dr. Jason Gurien <br /> Street Address: c/o Matson Custom Homes, Inc . .. <br /> City, State, Zip: Stoughton, WI 53589 <br /> This property is: residential commercial agricultural manufacturing(circle one) <br /> Parcel # 002/0512-054-7057-0 • <br /> Construction location: North/South/East/West Side of Eldon Way <br /> (Road on which access is located) <br /> located from <br /> (Intersection of town/town or town/county rd) <br /> in Section 25, Town of Albion. <br /> ATTACH A DRAWING OR MAP SHOWING ACCESS LOCATION ON ABOVE <br /> PROPERTY. Specify footage from lot lines and show all existing accesses. <br /> Stopping Site Distance Available: <br /> Posted Speed Limit: <br /> Stopping Site Distance Required at Posted Speed Limit: <br /> Remarks: <br /> NOTE: Stopping sight distance for driveways is measured with an eye height of 3.5 feet above <br /> the pavement and an object height of 0.5 feet above shoulder elevation. To Determine "Stopping <br /> Sight Distance", please refer to the DOT Values Table. <br /> C:\Users\Albion\Documents\DRIVEWAY APPLICATION&PERMIT.docx 1 <br /> 4/24/06 <br />