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, ,;rye 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 /> Nick Hartwig Y <br /> Street Address Town,Village,City Section <br /> Lot 1 -Hwy Y Town of Roxbury 18 <br /> City State Zip <br /> Sauk City WI 53583 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608)370-2008 (608)588-4105 nhartwigckraemerbrothers.com <br /> Existing Access? If yes,how modified? <br /> Yes ❑ Relocated ❑ Removed 0 Change of Use ❑ Culvert Replace [] Asphalt Paving <br /> Describe Use: <br /> Access to new residence <br /> North/South/EasWVest Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> North USH 12 1000 feet west of CTH Y A-2 © Yes ❑ No <br /> Type of Permit Requested: <br /> 1 .1 $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 0 $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 12/04/2016 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 17A001 <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. Existing access to Lot 1 of CSM 10666 as <br /> constructed meets current requirements and does not require modification. No concrete pavement is allowed in the right-of- <br /> way. <br /> Check#2033 <br /> By i 01/03/2016 <br /> 'nature of Dane County Representative Date <br /> /- Greggar Petersen Highway Engineer 608-266-4036 <br /> Name and Title Phone <br /> Page 1 of 2 <br />