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! mot.- <br /> LIT--fStVN OF DUNN PARCEL #: 28-0610- <br />; DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: r -F <br /> SECTION 1- SITE VERIFICATION <br /> Applicant Name: L -.\ti.L fv\ E.CGASc; (Tii Pau! fie:.\ Le p,it):pate: <br /> Address: 1 01,1, '',..-e, v :; Oi.. 1 III t'1i; i:,,t..:, i 1 J41 '3310C Phone#: <br /> Purpose: E1 Residential ❑ Field Road Access ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: 'w-�ra -.If ri<L*A <br /> . <br /> Proposed Driveway Location: L ;� <br /> ;r 1 6� ,a,,., t t.r. 0il.i i€ (1C{y 1 ' <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# X Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? Li yes ❑ no (If no, attach copy of easement.) <br /> Bldg. Site Verification Date Comments <br /> SECTION 2 - SUBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Diagram Showing: Other: <br /> AProperty slopes. ❑ Copy of any required Dane Co. erosion control plan. <br /> , Driveway slope. ❑ Other <br /> ❑ Driveway turnaround. <br /> 0 Location& structure of retaining walls. <br /> ❑ Length,width&radius of driveway curves. <br /> ❑ Driveway cross section showing depth&fill material. <br /> ❑ Drainage culvert, ft. length, in.diameter. <br /> i ❑ 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 hereby agree to construct the described work in accordance with the plans and specifications filed. <br /> Signature of Applicant 'Date <br /> � bltc W �orenan Initial Construction Approval Date Permit Issued Permit Fee <br /> ... .f .,C , i / f (�y f r $ t..�±j to . <br /> SECTION 3 - FINAL APPROVAL ^� I <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 />