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17. ®Yes 0 No Is the property zoned? Provide documentation from the jurisdictional zoning authority.
<br /> 18. Explain how the land is currently being used: Currently Vacant Zoning is RH-1
<br /> 19. 0 Yes ®No Are you aware of any plan to change the zoning or land use
<br /> for the property? If yes,explain.
<br /> 20. ®Yes 0 No Is this connection for property that was part of a land division
<br /> or assemblage created on or after 2/1/99? II yes,explain. Larger parcel was split to sell a smaller residential lot
<br /> 21. 0 Yes ®No Do you own other property abutting the highway that is next
<br /> to the property that this connection will serve? If yes,
<br /> describe,
<br /> Note 1:Answering'yes"to#20 or 21 may result ins Wis.
<br /> Administrative Code Trans 233 review by WisDOT.If this is
<br /> needed,the processing of your application may be delayed.
<br /> 22. 0 Yes ®No Does the property abut or border another public road? If yes,
<br /> provide the road's name.
<br /> 23. ®Yes 0 No Are there any existing connections to any road serving the property? If yes,how many? 2
<br /> 24. 0 Yes ®No Are there any restrictions on the number,use,or location of connections to the property?
<br /> 25. 0 Yes ®No Are there any access easements across the property(recorded or unrecorded)?
<br /> Note 2: If you answered yes"to#24 or 25.provide a copy of
<br /> all documents relevant to the restrictions and/or easements
<br /> 26. Provide the property tax identification number: 0507-111-8010-4
<br /> 27. What is the proposed construction completion date for the connection? See Conditions of Issuance#9. 06-15-2016
<br /> FOR ANY NEW CONNECTION OR CONNECTION TO BE MOVED, APPLICANT SHALL PLACE A FLAG OR MARKER IN THE
<br /> HIGHWAY DITCH OR FORESLOPE(VISIBLE FROM THE HIGHWAY)AT THE PROPOSED LOCATION.
<br /> CONDITIONS OF ISSUANCE
<br /> 1. WisDOT reserves the right to make such changes,additions,repairs,relocations and removals within statutory limits to the connection or its appurtenances on
<br /> the right-of-way as may at any time be considered necessary to facilitate relocation, reconstruction,widening,and maintenance of the highway,or to provide
<br /> proper protection to life and property on or adjacent to the highway,or if alternative access to the property becomes available.
<br /> 2. Except in cases where the indicated connection may be constructed by forces acting on behalf of WisDOT due to a highway improvement or maintenance
<br /> project,the permittee shall do all of the following: (a)Furnish all materials,do all work,and pay all costs for the construction and maintenance of the connection
<br /> and its appurtenances on the right-of-way.Materials used and the type and quality of the work shall be appropriate for the connection type specified in this permit;
<br /> (b) Do all work without jeopardy to, or interference with, traffic using the highway; (c) Promptly restore to WisDOTs satisfaction and at least pre-existing
<br /> conditions,highway surfaces,shoulders,ditches,vegetation,drainage appurtenances,guardrail,signs,electric conduits/cables,etc.disturbed by any work: (d)
<br /> Maintain the connection and its appurtenances within the rightol-way limits,which includes keeping them in a proper state of repair,preventing the blockage or
<br /> impairment of right-of-way drainage,and preventing aboveground obstacles to occur that could cause serious injury or death to a motorist in an errant vehicle; (e)
<br /> Not disturb or cause the disturbance of any survey marker without the prior written approval of WisDOT.
<br /> 3. The permittee,indicated on the reverse side,represents all parties in interest,and agrees that any connection or approach constructed by or for the permittee
<br /> is for the purpose of obtaining access to the property(listed in#26)and not for the purpose of parking or servicing vehicles,or for advertising,storage, or
<br /> merchandising of goods on the right-of-way.
<br /> 4. The permittee shall not make any changes to the connection,its appurtenances,or adjacent right-of-way,Including,without limitation,changes to the location
<br /> (0441),use(#13),width(#14),surface(#15),or increase the number of trips per day(#16)approved by this permit without obtaining prior written approval from
<br /> WisDOT.WisDOT will evaluate all potential highway impacts that may arise from the proposed change(s)and therefore,does not guarantee approval.
<br /> 5. The permittee,successors or assigns agree to hold harmless the State of Wisconsin and its duly appointed agents and employees against any action for
<br /> personal injury or property damage sustained by reason of the exercise of this permit.
<br /> 6. WisDOT does not assume any responsibility for the removal or clearance of snow,Ice or sleet,or the opening of windrows of such material upon any portion of
<br /> any connection along any state trunk highway even though snow,ice or sleet is deposited or windrowed on said connection by its authorized representative
<br /> engaged in normal winter maintenance operations.
<br /> 7. Under Wisconsin Administrative Rule Trans 401,the permittee shall implement proper erosion control and storm water management measures at as times
<br /> during work operations and upon completion of the connection to protect all restored areas until the replacement vegetation achieves sustained growth.
<br /> 8. Rock,asphalt,concrete,timber or other embankment retention or marking treatments for the connection are orohiblted.
<br /> 9. If the permitted work has not been started by the construction completion date,this permit is null and void.If the work has been started but is not finished by
<br /> the construction completion date,no additional work shall be done unless authorized through an approved written time extension or a subsequent permit from
<br /> WisDOT.Accomplishment of any part of the work shall verify agreement by the permittee to conform to this permit and to be bound by all of its requirements,
<br /> restrictions,and obligations,all of which shalt continue to be In full force and effect.WisDOT does not guarantee the approval of a time extension or subsequent
<br /> permit since the conditions WisDOT based its permit approval upon may have changed between the permit approval date and time extension request date.
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