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4 Dane County Department of Public Works, Highway and Transportation <br /> k ` 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 /> Shaw Building & Design N <br /> Street Address Town,Village,City Section <br /> 3185 Deer Point Drive Town of Dunkirk 21 <br /> City State Zip <br /> Stoughton WI 53589 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)877-1131 (608)877-1131 (608)873-8736 mark @shawbuilders.com <br /> Existing Access? If yes,how modified? <br /> No ❑ Relocated ❑ Removed ❑ Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> New single family residence <br /> North/South/East/West Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> N Hogie Rd 450 feet east of Hogie Rd RH-2 0 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 M $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 7/2/2015 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 15A018 <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 approvals and applicant must <br /> comply with all federal,state and local laws,ordinances and regulations. <br /> The access must be graded to drain away from the edge of road for a minimim of 8'. A 21"x 15"eliptical culvert <br /> approximately 30 feet long with approved apron endwalls is required. No concrete pavement is allowed in the highway <br /> rightofway. <br /> Check#28372 <br /> By eat 7/9/2015 <br /> -r.?'ature of Dane County Repr tative Date <br /> eggar Petersen Highway Engineer 608-266-9081 <br /> Name and Title Phone <br /> Page 1 of 2 <br />