Laserfiche WebLink
TOWN OF MADISON Application No. <br /> • 2120 Fish Hatchery Road <br /> Madison Wisconsin 53713 Date 2 l 2- l 6 Ad <br /> APPLICATION FOR DRIVEWAY PERMIT <br /> (Drawing must be attached in duplicate) <br /> Location 401 W, 6e-(4-b vie_ ii w y, <br /> / Parcel Number <br /> Property Owner Rod $rvv\e,,r — Ker., Kew+..; <br /> Name of Company and Owner or Agent Telephone Number <br /> Job Contractor ( no vte. -4-14-is -€.) <br /> Type of Driveway: Class I Class II ✓ (check one) <br /> Width 24, Feet; krZ I Feet from Property Line; t4 k Feet <br /> from right-of-way line of.ntersection; Shoulder construction /v A <br /> or raised curb ✓ (check one) Edge Radius feet; Angle to <br /> pavement edge _ q() °; Grade of approach % ° <br /> Plantings on right-of-way area 4-r S <br /> (grass, flowers or low growing shrubs) <br /> (Attached drawing shall show the following: Driveway and approaches; property lines; <br /> right-of-way lines; adjacent intersecting roads, streets or railways within 100 feet; width <br /> and type of road surface; width of right-of-way; distance from right-of-way line to <br /> gasoline pumps and other structures on the site; type of surface and width of driveways; <br /> type of surface and width of approaches; proposed turning radii; proposed treatment of <br /> right-of-way area adjacent to and between approaches; rate of slope or grade of <br /> approaches and driveways.) <br /> Special provisions:�Proof of ublic liability insurance r <br /> Pr�,M■dt �r-oee J la 4p 4 4 <br /> 1h5ivlr nC2 �0-+� C�'''`5 L o-'''\. <br /> Applicant does hereby agree to conform with all requirements of Town of Madison <br /> Ordinance No. 4-3-1 and 4-3-2. <br /> Approved 1(49‘ 1- roz 4J 4400z <br /> Applicant Signature/-0,, JZ,?---- --C--ZC/‹) <br /> jc)._ <br /> Printed Name <br /> I ., -1r <br /> Director of Public Wor <br /> Date 5 -2,5 - 0$ Fee 25. o TR# 3 <br /> joLP <br />