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TOWN OF DUNN PARCEL #: 28-0610-61/- ^ZZ D <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: /05/_3 <br /> SECTION 1 -SITE VERIFICATION <br /> "r <br /> Applicant Name: ScaTT 4. Ci( lrc-��. ( )1 LP/ 1 Date: 6/Z.1/Zc.1/4 <br /> Address: / • Alitbi io/a Phone#: --.575 j <br /> Purpose: �Residential ❑ Field Road Access ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: 3e.()r! ' U f j LIL M,L y iJ <br /> Proposed Driveway Location: 2,6)24 lJ i(0714 . "146C.400/11)r 62:7/I <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# }' Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? 'X yes ❑ no (If no, attach copy of easement.) <br /> Bldg.Site Verification , Date. Comments <br /> I <br /> 1301 , ; c e a. ek � G ' � P .. <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. <br /> ❑ Driveway cross section showing depth& fill material. <br /> Drainage culvert, ','i ft. length, in. diameter. <br /> ❑ Driveway relationship to property lines, structures&roads. Center of driveway feet from <br /> • <br /> The undersigned applicant as owner,or as owner's agent, does hereby attest that all the information provided is true and <br /> accurate and does hereby agree to construct the described work in accordance with the plans and specifications filed. <br /> �z /2(46 <br /> Signature of Applicant Date <br /> Public Works Fe = an Initial Construction Approval Date Permit Issued Permit Fee <br /> $ <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 />