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Dane County Department of Public Works, Highway and Transportation <br /> ACCESS PERMIT <br /> rise <br /> This permit is required and shall be issued in accordance with the provisions of Section 83.027 of the Wisconsin Statutes and Chapter 79 of the Dane <br /> County Code of Ordinances. <br /> Name Co.Trunk Hwy in which access is requested: <br /> Dennis Midthun J <br /> Street Address Town,Village,City Section <br /> 13845 W Bullard Rd Town of Springdale 23 <br /> City State Zip <br /> Evansville WI 53536 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)444-4797 midthun @hotmail.com <br /> Existing Access? If yes,how modified? <br /> No ❑ Relocated ❑ Removed ❑ Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> Joint Drivewy 1 lot and farm <br /> North/South/East/West Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> East CTH G 3,795 feet south a-1 Non Exc 0 Yes ❑ No <br /> Type of Permit Requested: <br /> ❑ $110 Temporary Controlled Access ❑ $75 Temporary Non-Controlled Access <br /> ❑ $110 Agricultural Controlled Access ❑ $75 Agricultural Non-Controlled Access <br /> ❑ $110 Residential (single family)Controlled Access ❑ $75 Residential(single family) Non-Controlled Access <br /> © $220 Residential,Joint Access>1 parcel ❑ $220 Commercial,<100 ADT** <br /> ❑ $1,100 Private/Public, New/Existing,Street or Road ❑ $550 Commercial,>1000 and<1,000 ADT <br /> ❑ $45 Miscellaneous ❑ $1,100 Commercial,>1,000 ADT <br /> ADT denotes Average Daily Traffic. Data substantiating ADT for access or road intersections may be required. <br /> Fees paid in full on 2/13/2015 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 15A003 <br /> The application submitted is hereby approved and this permit is issued by Dane County subject to full compliance by the Applicant with all provisions <br /> and conditions stated herein and on the reverse side hereof and all attachments hereto. <br /> Other Special Provisions: <br /> This permit is contingent on all other Local,State and/or County Agency permits,zoning and approvals and applicant must <br /> comply with all federal,state and local laws,_ordinances and regulations. Note the driveway access s point has been re vised_ <br /> so that the driveway distance is now 3,795'and not 4,135'. (April 14,2015. GAP) <br /> The access must be graded to drain away from the edge of road for a minimim of 8'and will require a new 18"diameter <br /> squash pipe 30 feet long with approved metal apron endwalls. <br /> Check#5090 <br /> By 3/12/2015 <br /> Signature of Dane County Representative Date <br /> Greggar Petersen Highway Engineer 608-266-9081 <br /> Name and Title Phone <br /> Page 1 of 2 <br />