Laserfiche WebLink
Permit Approval by Permitting Authority <br /> The foregoing application is hereby approved and permit issued by the Permitting Authority subject to full <br /> compliance by the Applicant with all provisions and conditions stated herein and all attachments hereto. <br /> Federal Aid has been,or is being,used on this highway;current State of Wisconsin policy for <br /> accommodation of utilities on highway rights-of-way applies. <br /> $1550. Permit fee applies(escrow$1500.for road damage that may occur;returnable to Applicant if no <br /> damages occur);($50.for the siting fee;non returnable) <br /> O her Special Provisions: <br /> t /- Title -e4 <br /> Signature of� Permitting Au or Representative <br /> g Date 4241,5-- <br /> 2. Title <br /> Signature of Authorized Permitting Authority Representative <br /> Date <br /> 3. Title <br /> Signature of Authorized Permitting Authority Representative <br /> Date <br /> Driveway Permit Receipt <br /> Name Aeffewle (B/ JN <br /> Address <br /> Building Address Site Q,t i) Vi ..I ' 41-&-04 <br /> Phone (home) (work) <br /> Amount escrowed $ _ /'SbC. <br /> Administrative/Inspection fee $ ;-c). '`-- <br /> Repair of Road Damage $ <br /> Amount Returned $ <br /> Return of Escrowed Fee $ <br /> Occupancy Permit issued on by <br /> Administrative/Inspection fee $ <br /> Repair of Road Damage $ <br /> Amount Returned $ <br /> Business Office Signature Date <br /> Copy for applicant Copy for office <br /> DRWAY Permit Procedure.doc Rev 4/16/15 5 <br />