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TOWN OFDUNN PARCEL #: 284)610-P93-1Iaa-7 <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: 70,3 <br /> SECTION 1- <br /> SITE VERIFICATION <br /> Applicant Name: 62,01.1 L r■ Date: S" i D S <br /> Address: 2.7/V tAlG43 /574h, 0Q Phone#: <br /> Purpose: Residential ❑Field Road Access ❑ Other <br /> (Bldg. site verification not required) <br /> Property Owner's Name: Gg21 r t <br /> Proposed Driveway Location: 711/ a9 m <br /> /Yy r t✓c. <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# Town Rd. ❑ Private Rd. <br /> . Does property owner own proposed driveway road frontage? ❑ yes1. 1 no (If no, attach copy of easement.) <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 y required Dane Co. erosion c• trol plan. <br /> VDriveway slope. ❑ Other ,� hilt <br /> 11 Driveway turnaround. - A .__!a �t <br /> � � , v � <br /> ❑ Location& structure of retaining walls. .04 / <br /> ❑ Length,width&radius of driveway curves. <br /> ❑ Driveway cross sectio showing depth& fill material. <br /> [V6.rainage culvert, ft. length, J in. diameter. /4--4-41k.---e-411-4d t )J <br /> ❑ Driveway relationship to property lines, structures&roads. Center of driveway feet from <br /> The undersigned applicant as owner, or as owner's agent, does hereby attest that all the information provided is true and <br /> accura and does hereby gree to construct the described work in accordance with the plans and specifications filed. <br /> Sire of Applicant Date <br /> SECTION 3 - FINAL APP-eV <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 />