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Dane County Department of Public Works, Highway and Transportation <br /> 'g. 1:1-.) 1 <br /> � - ACPESS PERMIT <br /> r ., v I <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 Kratzke-Jim Kratzke Homes, LLC Y <br /> Street Address Town,Village,City Section <br /> 441 Park Ave Town of Roxbury 18 <br /> City State Zip <br /> Prairie du Sac WI 53578 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)512-9022 jimkratzkedesigns @hotmail.com <br /> Existing Access? If yes,how modified? <br /> Yes ❑ Relocated ❑ Removed © Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> Joint use <br /> North/South/EastNVest Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> CTH Y Northside STH 78 1290' east Single Family © 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 El $220 Commercial,<100 ADT** <br /> ❑ $1,100 Private/Public, New/Existing,Street or Road ❑ $550 Commercial,>1000 and<1,000 ADT <br /> ❑ $45 Miscellaneous El $1,100 Commercial,>1,000 ADT <br /> **ADT denotes Average Daily Traffic. Data substantiating ADT for access or mad intersections may be required. <br /> Fees paid in full on 9/10/2009 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 09A016 <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 /> Joint use access granted for new single family home and existing residential home. <br /> 2 / , <br /> By 9/28/2009 <br /> �igraature of Dade County Re• -sentative l" Date <br /> 6."-S- <br /> Greggar Petersen Highway Engineer 608-266-9081 <br /> Name and Title Phone <br /> Page 1 of 2 <br />