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0/24cs <br /> TOWN OF DUNN PARCEL #: 28-0610-052-717 . <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PE. - , <br /> SECTION 1-SITE VERIFICATION 963 / , 00 <br /> Applicant Name: Te P,U)7,elc,/,4 Date: — <br /> Address: .21` S. Ski Z7 ' I SE LLEJIL- 61v1.2„ Phone#: <br /> Purpose: )(Residential 0 Field Road Access 0 Other <br /> (Bldg.site verification not required) PPTEV PG i <br /> Property Owner's Name: 2-/�Ai REV T2.j c l/ a,t <br /> Proposed Driveway Location: 2 9 2vd l,C.l esi t y e <br /> Driveway will provide access to: 0 US/Co.Hwy Permit# XTown Rd. ❑ ' • 'a e ''d. <br /> Does property owner own proposed driveway road frontage?)(yes ❑no (If no,attach copy of easement.) <br /> ;v.....•. �� ..� !'1 r -mot <br /> .z <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 /> 0 Driveway slope. Jar Other ei <br /> ❑ Driveway turnaround. /� <br /> ❑Location&structure of retaining walls. G/ <br /> ❑ Length,width&radius of driveway curves. <br /> ❑Driveway cross section showing depth&fill material. <br /> ❑ Drainage culvert, ft.length, in.diameter. <br /> ❑ Driveway relationship to property lines,structures&roads.Center of driveway feet from <br /> The undersigned apps' .nt as owner,or as owner's agent,doeMFiy attest that all the information provided is true and <br /> accurat d di s •y - e to construct the described west in accordance with the plans and specifications filed. <br /> Signature of Applicant Date <br /> _ 1:_ <br /> _- t j �� W-1;-;":41 <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 Mils tuthorized 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 />