Laserfiche WebLink
• TOWN OF DUNN PARCEL #: 14-0610- 02) -q ,0-Q <br /> . DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: <br /> SECTION 1- SITE VERIFICATION <br /> Applicant Name: s�- S-.: f�/Z ! I !dp J, Date: / /1 /i j/7 <br /> •Address: 22t -14 .i-15 'k. Pt, . f' 4 )&fJjl.J WI Phone#: 222- l`I'7f <br /> Purpose: E Residential ❑ Field Road Access ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: _ c,-). "T ,S 4 ci-`` L 4 . (.{)/I.:: >ti1 <br /> Proposed Driveway Location: i r''"`, -1J'L .t.ii i V/1_a)/.-1 / T-7-1 z/,,,,,,-//:...., .7)// c>I <br /> r,-1 ?71-4 . 7 61/?,0t-/C, ,4 C.UC LO `..i4C. <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# a Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? l yes ❑ no (If no, attach copy of easement.) <br /> Bldg.Site Verification Date Comments <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 0-o- tr-7 57/(_. /tt,ci,„„'l____ <br /> ❑ Driveway turnaround. <br /> 0 ❑ Location&structure of retaining walls. . <br /> ❑ Length,width&radius of driveway curves. e .d_P <br /> ❑ Driveway cross section showing depth&fill material. <br /> rr <br /> Y Drainage culvert, < '/` ft. length, -- � ,e f 6 ` C C 1 (2 il <br /> ❑ Driveway relationship to property lines, structures&roads. Cent( / i 6 -om <br /> The undersigned applicant as owner, or as owner's agent, does hereby attest that all the information provided is true and <br /> accrte and does hereby agre7to construct the described work in accordance with the plans and specifications filed. <br /> '-- <-1( \k (/)/(__:---)L__J / 1 / 11 /--)3 <br /> <_- Signature of Applicant Date <br /> Public Works Foreman Initial Construction Approval Date Permit Issued Permit Fee <br /> SECTION 3 - FINAL APPROVAL <br /> ❑ The Town of Dunn has inspected the above field road and determination has been made that it meets <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 />