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8254864 Village of Sun Prairie 11:56:09 a.m. 02-16-2016 1 /2 <br /> Town of Sun Prairie Driveway Permit Fee: $50 <br /> Road Damage Escrow: $1500. <br /> 5556 Twin lane Road <br /> Marshall, WI 53559 Location: ,14'/. ■ -_- 1 • . <br /> Nela Cc,1 — its Ca--1 z/3 51' . <br /> 1/4 of %t/`F, / 1/4, Sec. /2::111e1 <br /> Application to Permit to Construct a Driveway / T"f3,.1- a 1 1 <br /> (Access from private property to a town road) <br /> REQUEST BY APPLICANT <br /> Name L //_ / ��ri/'> 7v tg" 4f ? Jj&e- <br /> Address qq _1 Dt. Z itilni L i'4 eattei j cf c <br /> ce phone /,,OS �al phone: Fax: /��r ,3/5,/c, ---.5 <br /> C' - L� ( 6rl) (!� <br /> PIans Prepared by ,,, e iji(, k Enclosed )(Yes No <br /> Location of Proposed North, South,Eas gaill Side of (2Ao <br /> Access: <br /> Section# Feet/Miles from <br /> The applicant understands and agrees that the permitted work shall comply with all permit provisions and conditions <br /> listed on the reverse side h eof, any special provisions listed below or attached hereof;and any and all plans,details <br /> or notes a ched hereto a made a part thereof <br /> By zez,,g Title <br /> gWt'ure o A icant <br /> Date Z _ 9_MCP <br /> Permit Conditions:Completed by Public Works personnel <br /> • Width of driveway ii / <br /> • Center of driveway from property ine: <br /> • Drainage Culvert Needed l (3/Drainage Culvert Needed <br /> Size: Length: a r feet <br /> Diameter I $ 1 inches <br /> All Culverts are to have ends <br /> Other All construction equipment must use this entrance to access lot.All Culverts must have ends : ': <br /> Requirements .(Wings),Culverts are to be completely installed prior to final inspection and approval by public <br /> works personnel <br /> No construction materials are allowed in the public roadway Damping of landscaping <br /> -niitterials(mulch, tone, opsoil,etc.)on the road will cancel the return of a$1, OO escrow. i <br /> Estimated Starting Date Estimated Completion Date W/„ <br /> ■ <br /> Notify the Town Office at 837 .688 wh•a project is completed. <br /> DRWAY Permit Procedure Rev 4/16/15 4 <br />