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8254864 Village of Sun Prairie 11:33:43 a.m, 06-30-2016 1 /3 <br /> Town of Sun Prairie Driveway Permit Fee: $50 <br /> Road Damage Escrow: $1500. <br /> 5556 Twin lane Road <br /> Marshall, W153559 Location: G c•7– / ■.E2C2,/GG. ieer/a.0 <br /> Scc) 1/4 of NE 1/4,Sec. 3 9 <br /> Application to Permit to Construct a Driveway <br /> (Access from private property to a town road) <br /> REQUEST BY APPLICANT <br /> Name <br /> S E AICIP G rS.v ter E2G, <br /> • Address y 9 8 9 4. i—, ZT <br /> Office phone _ Local phone: Fax: <br /> G 12g/4 45-8oyq <br /> Plans Prepared S� "c% <br /> P by f ..„2E arit,E (� Acrni2s py Enclosed x Yes No <br /> Location of Proposed North South,East, West Side of 92eEV• Road <br /> Access: <br /> Section# 3 y Feet/Miles from Ave,O e.„96,_ o,= AA`1 <br /> The applicant understands and agrees that the permitted work shall comply with all permit provisions and conditions <br /> listed on the reverse side hereof,any special provisions listed below or attached hereof,and any and all plans,details <br /> or notes attached hereto and made a part thereof. 7 <br /> CDi��j8 ��l�` <br /> By 0# / !/l�l/���G Title •�) J ,/f.YY1Ef7YGE , nige1A?b <br /> '� Applicant Date _(�� <br /> G — 7—/Lo <br /> Permit Conditions:Completed by Public Works personnel <br /> • Width of driveway <br /> • Center of driveway from property line: ,, / <br /> • Drainage Culvert Needed No Drainage Culvert Needed /� l 6 Gil//� "1 <br /> Size: Length: feet je),e/t--, i4 0 <br /> Diameter inches <br /> • <br /> All Culverts are to have ends <br /> Other Requirements: All construction equipment must use this entrance to access lot.All Culverts must have <br /> ends(wings).Culverts are to be completely installed prior to final inspection and <br /> approval by public works personnel. <br /> Estimated Starting Date Estimated Completion Date <br /> Notify the Town Office at 837-6688 when project is completed. <br /> DRWAY Permit Procedure.doc Rev 4/16/15 4 <br />