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TOWN OF DUNN PARCEL # 28.0610- I(p } <br /> -- `I I'�+'l _~ <br /> • DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: <br /> SECTION 1- SITE VERIFICATION <br /> Applicant Name: Jr.)t �r ��c Date: i f()/U`1 <br /> Address: ,�� C (,t,1 r`)t c ,: 1 1.. �,� S� Phone#: '"',sl � „4 "� <br /> Purpose: gResidential ❑ Field Road Access J ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: 5 2}T, /4& S,e5Nr4 <br /> Proposed Driveway Location:L-]- l\)6 i , -7(1.6t)61/4. t(3 ' <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# [ ,Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? Ayes yes ❑ no (If no, attach copy of easement.) <br /> Bldg,5�V�catio D Comments <br /> ff <br /> ' (T T:. .. "rte <br /> l <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 <br /> ❑ Driveway turnaround. <br /> ❑ Location&structure of retaining walls. <br /> ❑ Length,width&radius of driveway curves. <br /> ❑ Driveway cross section showing depth&fill material. <br /> l Drainage culvert, ii <, ,, ft. length, '`> in. diameter. '• °', �'`' "f L <br /> ['Driveway relationship to property lines, structures&roads. Center of driveway /ill" feet from <br /> Natal / 'r�k <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 hereby agree to construct the described work in accordance with the plans and specifications filed. <br /> II A <br /> /fc/t i <br /> Signature of Applicant I Date <br /> Pules g i an ttal Construction Approval Date Permit:Issued Permit Fey <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 /> the 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 />