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Distance from the side setbacks of the property <br /> Zoning classification of the subject property <br /> Number of feet from intersections of any town/town or town/county roads:__ <br /> req.t._re <br /> 1. Finished accesses must remain at, Cr below, the grade of the roadway edge for a minimum of ten feet. <br /> 2. Access base shall be in place prior to the start of constriction and all vehicles entering the property shall use <br /> the access to protect the roadway edge. <br /> 3. In the event a culvert is required, said culvert shall be covered by sufficient material to protect it from the <br /> weight of vehicles using the access. <br /> 4. Placement and maintenance of culvert is the responsibility of the property owner. <br /> 5. All dimensions and construction of accesses will adhere to Dane County and Town of Pleasant Springs <br /> standards. <br /> 6. Nothing may be placed in the public right-of way except legally constructed mailboxes. <br /> 7. The Property owner is responsible for damage to road edge caused by demolition and/or construction. <br /> r <br /> d <br /> °P-1 . .:-r:e1oo.a ai C,^3-[,i4- . 15 ..n_.. _ ... ._,_�,. o _'.,�_ `lit^J <br /> ter, ,._. <br /> _.. vVU- .J-� -l._ A�,- ..'J��,.11:..1 .1 u.,'..r .. .1`J ' v <br /> t l 2 .�ublic Y/Dec'.;3 ie aria.so nt ..a 603-205.9159.: 'i corn ialfa?i`l. certificate. <br /> D v 1 L EDGEM.t,ITT: <br /> As owner of the above named property, I acknowledge and agree that I am responsible for all damages I cause, <br /> or caused by any contractor or agent retained by me, to the roadway, shoulder, or right-of-way that occurs as a <br /> result of the demolition and/or construction process, including damage caused by equipment traveling to the <br /> work site, up to and including such time as an occupancy permit and/or completion certificate from the TOPS <br /> Building Inspector or Public Works Staff is issued and received by the Clerk. I agree that the damage deposit of <br /> $1000.00 will be deposited and retained by the town until the Town Board acts to release the deposit. Costs for <br /> any damage, determined solely by the Town Board, will be deducted from the deposit prior to return. I <br /> understand that no deposit will be returned until: <br /> a. Inc Occupancy Permit has been issued by the Town of Pleasant Springs Building Inspector, or <br /> b. A Completion Certificate has been issued by the Public Works Staff, and <br /> c. The Town Board acts to approve the release of all, or a portion of, the deposit and requests a check to <br /> be issued to the property owner. <br /> If the damages exceed the damage deposit,I agree to promptly reimburse the Town upon receipt of an invoice <br /> detailing same. I agree that unpaid amounts will accrue interest at a rate of 1.5%per month. <br /> 0-,-( erA <br /> Property Owner Signature Date <br /> Approval of initial access �t 16/1-k /q <br /> Town Representative e -Lt <br /> Date Deposit Received: Date Deposit authorized to be retuned: <br /> Date Deposit Returned by Treasurer: <br /> Additional Access Granted/Denied by Town Board on: Reason for denial: <br /> L <br /> 01/22/2015 <br /> C:\Uscrs\marciaVP.ppData\Loc d\T.dicresofdWindOWsVl•empor:ry L';tcrnct Fiics\Contc11l.1t5\KNSKSY2F.\access permit updated 2015-doe <br />