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AWN OF DUNN PARCEL #; 28-0610- <br /> ` fRVEWAY CONSTRUCTION PERMIT APPLICATION <br /> PERMIT #: 11)Gq <br /> /SECTION 1-SITE VERIFICATION s3 , <br /> Applicant Name: 5715''11 all J. Do44 M <br /> Address: 28.M1°(� NENS}I 1,?.� p " � Date: 1e://. 1 <br /> � �!� Phone#:(pQ�' py.�(� S0 <br /> Purpose: N�Reesiid,ential ❑Field Road Access ❑ Other " <br /> 4 <br /> (Bldg.site verification not required) *. <br /> Property Owner's Name: S F-4/E"J ,,J tT +i \ <br /> Proposed Driveway Location: /Q -- 1661 <br /> 5,0-T'H og Exts-ri4c, DR(/E aFr- <br /> 14-EN SHOE MAD <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# <br /> ,IK Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage?g gyes ❑ no (If no, attach copy of easement.) <br /> B14 .Site Venficarioi� bate Cou�ments ; . ,, / <br /> ti^1•ice: a 7 s <br /> iC <br /> dt> ° ° s Pr F <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. ❑ Co py 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. • r <br /> O.Drainage culvert, < / ft. len h // 1 <br /> length, f� in. diameter. �/�/ta/�'a <br /> ❑ Driveway relationship to property lines, structures&roads. Center of driveway feet from <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 here y agree'to construct the described work in accordance with the plans and specifications filed. <br /> Signature of Applicant / 1 /2 U (- <br /> 3� Tt�ate <br /> P Ate-...® har S .f#t �['ii09 t.ANti V 'li Yaa <br /> t aa m <br /> iit r r <br /> ur <br /> s t - iii z i.7d �w n <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 ofublic Works Foreman <br /> White- Town Yellow-Applicant Pink-Dane Co. Zoning <br />