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Dane County Department of Public Works, Highway and Transportation <br /> ACCESS PERMIT <br /> This permit is required and shall be issued in accordance with the provisions of Section 83,027 of the Wisconsin Statutes and Chapter 79 of the Dane <br /> County Code of Ordinances. <br /> Name Co.Trunk Hwy in which access is requested: <br /> Erik Ranheim J <br /> Street Address Town,Village,City Section <br /> 3900 Meridian Circle Town of Vermont 21 <br /> City State Zip <br /> Verona WI 53593 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)217-2446 (608)263-0057 (608) 265-6215 earanhelm @wisc.edu <br /> Existing Access? If yes,how modified? <br /> No ❑ Relocated ❑ Removed ❑ Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> Single Family Residential <br /> North/South/Eastiwest Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> West County Road JJ 380 feet west RH 1 © Yes ❑ No <br /> Type of Permit Requested: <br /> ❑ $110 Temporary Controlled Access ❑ $75 Temporary Non-Controlled Access <br /> ❑ $110 Agricultural Controlled Access ❑ $75 Agricultural Non-Controlled Access <br /> ❑ $110 Residential(single family)Controlled Access 5 $75 Residential(single family) Non-Controlled Access <br /> ❑ $220 Residential,Joint Access>1 parcel ❑ $220 Commercial,<100 ADT** <br /> ❑ $1,100 Private/Public, New/Existing,Street or Road ❑ $550 Commercial,>1000 and<1,000 ADT <br /> ❑ $45 Miscellaneous ❑ $1,100 Commercial,>1,000 ADT <br /> `ADT denotes Average Daily Traffic. Data substantiating ADT for access or road intersections may be required. <br /> Fees paid in full on 1/9/2013 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 14A001 <br /> The application submitted is hereby approved and this permit is issued by Dane County subject to full compliance by the Applicant with all provisions <br /> and conditions stated herein and on the reverse side hereof and all attachments hereto. <br /> Other Special Provisions: <br /> This permit is contingent on all other Local,State and/or County Agency permits and requirements. A 15"x 21"diameter <br /> culvert 30 foot long with 2 apron metal endwalls is required. This permit supercedes old permit 07A008. <br /> Enclosed is the Culvert Selection Chart for Entrances. Note in the cross-section,that water must drain 8 to 10 feet away <br /> from the edge of the existing shoulder. <br /> Traffic control shall be as per the MUTCD. <br /> Check#2461 <br /> By 1/10/2014 <br /> S' rt- a of Dane County Rep entative Date <br /> eggar Petersen Highway Engineer 608-266-9081 <br /> Name and Title Phone <br /> Page 1 of 2 <br />