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TOWN OF DUNN PARCEL #: 28-0610- z 39'e -*.e'5 <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: ireL99' <br /> `^, / <br /> SECTION 1-SITE VERIFICATION —--°°°M <br /> Applicant Name: j\iefnv\ CA,,,\ 1. L\ 1(N o..\--, ;,,- .4-cI Date: — - 6 <br /> Address: "Z 1 q 7 Co 11 eNt\ ` , ;?0,..\- \ c- , Phone#: i<L? ; ZZS-Lj zl <br /> Purpose: (Residential 0 Field Road Access 0 Other <br /> (Bldg.site verification not required) <br /> Property Owner's Name: 11 icr c,", a,.A 1,A,`\ \0 c.t,ir„t r <br /> Proposed Driveway Location: CA.WV{ <br /> Driveway will provide access to: ❑US/Co. Hwy Permit# vf Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? ❑ yes ❑ no (If no,attach copy of easement.) <br /> BId Sit Verification Dale i Comments <br /> Wiailb <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 /> O Driveway slope. 0 Other <br /> ❑ Driveway turnaround. ' <br /> Li Location&structure of retaining walls. _��% <br /> � 07- d ;F <br /> �' Length,width&radius of driveway curves. �,/ T„c /c ��/v��/ /����'..�r' <br /> ❑ Driveway cross section showing depth& fill material. /V �p,,ty, cir tVc':v; / ` / 4' <br /> ft.length, ,-._....._.._._ in. diameter. ,c3 r ems°► e'40'0. ,� /?O l <br /> _l Drainage culvert, °—`�"" gt �� J <br /> ❑ Driveway relationship to property lines,structures&roads.Center of driveway / feet from c '1/Vim'%o <br /> Lu - ` ` 4/le • <br /> The undersigned 01ic- as •, ner'o as-ow r s agent,does hereby attest that all the information provided is true and <br /> accu - and es •: eby 1,4:e t•,,,,.0'Ali a i 1: •:, •=•, ork in accordance with the plans and specifications filed. <br /> '4://frAirrArAilir <br /> ' —'" :igriat.re of A.. icant Date <br /> Public yks Jr n.I ' '.1 C. coon Approval Date Permit Issued Permit Fee o' <br /> � V—l ' ' $ 1,Oa°— <br /> SECTION 3 - FINAL APPROVAL <br /> O 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 />