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TOWN.EQUNN 0 Ok0 q/&4 grtk 0 0 <br /> PARCEL #: 28-0610- g7 / 60 `' <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: 0 2Q <br /> SECTION 1-SITE VERIFICATION <br /> • <br /> Applicant Name: _' _ Date: Zi Zc(S✓ <br /> Address: ( , . — -`f --_ 9hill <br /> i <br /> ( �-t. Phone#: <br /> Purpose: [ Residential ❑Field Road Access ❑ Other <br /> //`` (Bldg.site verification not required) j, I <br /> Property Owner's Name: ¶ AJ it\_.A.i� lLn.ti tom,,. Ltt. 0.4 s& Gtk-c_C�C itu:-t <br /> Proposed Driveway Location: pi tl�P ,CCU ( {.- 9s-(;(c.(t -L/Q ,'DO T (, 'St <br /> Driveway will provide access to: ❑US/Co. Hwy Permit# gTown Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? ❑yes ,no (If no,attach copy of easement.) <br /> SECTION 2 -SUBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Diagram Showing: Other: <br /> ❑ Property slopes. Copy of any required Dane Co.erosion control plan. <br /> ❑ Driveway slope. ❑ Other <br /> ❑ Driveway turnaround. <br /> ❑ Location& structure of retaining walls. <br /> ❑ Length,width&radius of driveway curves. 1 <br /> ❑ Driveway cross section showing depth&fill material. <br /> ❑ Drainage culvert, .'�':' ft.length, tialh 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 /> a . rate and doe A•: • , :•ree to construct the d:scribed work in accordance with the plans and specifications filed. <br /> ■ ,� <br /> Zo <br /> Signature I f Applicant D to <br /> 4 'b b • P <br /> 6 a �� sa�. �i� rerta��.���1���- �ay_s �+aacat� P�� :e <br /> SECTION 3 - FINAL • PPROVAL A j� <br /> lv_c� o � <br /> ❑ The Town of Dunn has inspected the above field road and deatio�n made that it meet <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 />