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TOWN OF DUNN PARCEL #: 28-0610- 3N_lb 56 -1 <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT # <br /> SECTION 1-SITE VERIFICATION <br /> Applicant Name: et,,`(eli e C'n c e,, Date: /1/30/,' <br /> Address: !g'00 groo aeS,'de Z4i 6#2,0- ;ee Phone#: <br /> 6-7T-3.2c/4— <br /> Purpose: (residential 0 Field Road Access 0 Other <br /> (Bldg.site verification not required) <br /> Property Owner's Name: Ooti n# 4 W N'1g2 Vor d v rj p/'. <br /> Proposed Driveway Location: 37( I.fJd Ph-)-% <br /> Driveway will provide access to: 0 US/Co. Hwy Permit# Town Rd. 0 Private Rd. <br /> Does property owner own proposed driveway road frontage?jt yes 0 no (If no,attach copy of easement.) <br /> BId ite erificitio Dated Commen • <br /> �1/ , U <br /> SECTION 2 - UBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Diagram Showing: Other: <br /> 0 Property slopes. ❑ Copy of any required Dane Co.erosion control plan. <br /> ❑ Driveway slope. ❑ Other <br /> 0 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 /> 0 Drainage culvert, ft.length, in.diameter. <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 /> accura and does hereby agree to construct the described work in accordance with the plans and specifications filed./3ol/s- <br /> Signature of Applicant Date <br /> Pub icyi.orpf ooxn Itial Construction Approval Date Permit Issued Permit Fee <br /> inedi <br /> th �C), p/ift?L [SECTION 3 - FINAL APPROVAL D{;y\Q,iatti pyt Iol,ti -l�i¢i y� ►"oc�{_ <br /> 0 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 />