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Dane County Department of Public Works, Highway a d Ty. F t%©rlll \! -- <br /> ACCESS PERMIT AUG 2 3 2007 Li <br /> This application and permit is required and shall be issued in accordance with 'i - pr. Siena of Section--8-3-5 t e <br /> Wisconsin Statutes and Chapter 79 of the Dane County Code of Ordinances. DANE CC DEPT 0= PUBLIC WORKS <br /> Applicant is to complete all.of the following requested information lea e •r nt .r I HWA & Ks.NSPORTATION <br /> County Trunk Highway to <br /> which access is requested: 1� <br /> Name <br /> 539 US /I/'G /A1 s1 e.4 <br /> Address <br /> 1-)--TZDA GAT s-SS & `t <br /> City — State Zip <br /> &e70 E7? —90 Q aa g9 07- Coot-/ fop 7y/ -Sit, 7 <br /> Home Phone Work Phone FAX <br /> Existing Access?: If yes, how modified? (check one): <br /> Yes 171,No 7 Relocated Removed ❑ Change of use Culvert replace Asphalt Paving <br /> Describe Use: S�,Q (Q <br /> Location(check one): ❑ Town ❑ Village ❑ City of C.,1-k2-1 S;E �,� Section I <br /> Name of Highway and North/South/East est si-: G l f..4._ V <br /> Name of nearest cross road: C S l-} K.a�l n n1,C-,. tzc( . <br /> Distance and direction from nearest cross road: 1°O_ M O RTI-k O F (<O S <br /> Existing Zoning: Zoning meets intended use?: Yes <br /> ❑No <br /> T Le of Permit Requested (refer to reverse side for explanation of controlled and non-controlled access): <br /> $110 Temporary Controlled Access n $75 Temporary Non-Controlle d Access <br /> $110 Agricultural Controlled Access __ $75 Agricultural Non-Controlled Access <br /> 2 <br /> ❑ $110 Residential(single family) Controlled Access . $75 Residential (single family)Non-Controlled Access <br /> 0 $220 Residential, Joint Access > 1 parcel ❑ $220 Commercial, <100 ADT** <br /> $1,100 Private/Public, New/Existing, Street or Road (_I $550 Commercial, >100 and<1,000 ADT <br /> ❑ $45 Miscellaneous $1,100 Commercial, >1,000 ADT <br /> **ADT denotes Average Daily Traffic. Data substantiating ADT rn,• - • • <br />