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T,,�` Dane County Department of Public Works, Highway and Transportation <br /> .. 0 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 /> Chris Miller B <br /> Street Address Town,Village,City Section <br /> 3186 Kinney Rd. Town of Christiana 27 <br /> City State Zip <br /> Cottage Grove WI 53527 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)206-1106 (608)877-1366 chris.miller.construction @ gmail.co <br /> Existing Access? If yes,how modified? <br /> No C Relocated [ Removed [1 Change of Use C Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> Single Family Residential <br /> North/South/EastNVest Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> South Clearview Rd. 1532 feet West of Clearview Rd RH 1 © Yes C No <br /> Type of Permit Requested: <br /> ❑ $110 Temporary Controlled Access C $75 Temporary Non-Controlled Access <br /> LI $110 Agricultural Controlled Access C $75 Agricultural Non-Controlled Access <br /> J $110 Residential(single family)Controlled Access $75 Residential(single family)Non-Controlled Access <br /> • $220 Residential,Joint Access>1 parcel C $220 Commercial,<100 ADT"' <br /> • $1,100 Private/Public, New/Existing,Street or Road C $550 Commercial,>1000 and<1,000 ADT <br /> ❑ $45 Miscellaneous C $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 06/23/2016 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 16A012 <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,zoning and approvals and applicant must <br /> comply with all federal,state and local laws,ordinances and regulations. <br /> New driveway access to be constructed approximately 1,532'west of Clearview Road. An 18"diamenter or equivalent(21"x <br /> 15")culvert 30 feet long with approved apron end sections is required.The driveway access must be graded to drain away <br /> from the edge of road for a distance of 8 feet. <br /> Check#17026 <br /> 06/08/2016 <br /> By <br /> 'r- <br /> ,St ature of Dane County Represen':,:ve Date <br /> ( Gieggar Petersen Highway - gineer 608-266-4036 <br /> Name and Title Phone <br /> Page 1 of 2 <br />