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/ ,, Pn)iit win Lk <br /> Driveway Permit Fee: $50 <br /> Town of Sun Prairie Road Damage Escrow: $1500. <br /> 5556 Twin lane Road <br /> Marshall,WI 53559 C'D c=...42_,VV■wh <br /> 1/4 of 1/4,Sec. <br /> Application to Permit to Construct a Driveway <br /> (Access from private property to a town road) <br /> REQUEST BY APPLICANT <br /> Name ,,;,,,(p 5 mU 1 R <br /> Address 96 Cl^N SOt n O <br /> Office phone Local phone: cce)195.41•2153 Fax: <br /> Plans Prepared by Copy Enclosed Yes X No <br /> Location of Proposed North •outh,East,West Side of --Dee f ect,et?v kh Road <br /> Access: <br /> Section# 17 Feet/Miles from <br /> The applicant understands and agrees that the permitted work shall comply with all permit provisions and conditions <br /> listed on the reverse side hereof,any special provisions listed below or attached hereof,and any and all plans,details <br /> or notes attached hereto and made a part thereof. <br /> By Title Q <br /> Siwiature of Applican <br /> Date Si-- / -- 4.2e/.6-Permit Conditions:Completed by Public World personnel U <br /> • Width of driveway <br /> /2 t <br /> • Center of driveway from prop line: <br /> • Drainage Culvert Needed N Drainage Culvert Needed <br /> Size: Length: CZ feet <br /> Diameter f k'' inches <br /> All Culverts are to have ends <br /> Other All construction equipment must use this entrance to access lot.All Culverts must have ends <br /> Requirements (wings).Culverts are to be completely installed prior to final inspection and approval by public <br /> works personnel. <br /> No construction materials are allowed in the public roadway.Dumping of landscaping <br /> materials(mulch,sto ;tops etc.)on the road will cancel the return of the$1,5 0 escrow. <br /> Estimated Starting Date /9' estimated Completion Date 7 ` /Se----_ <br /> Notify the Town Office at 83 46888 en project is completed. <br /> DRWAY Permit Procedure Rev 4/16/15 4 <br />