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( PE l / <br /> ,rif Li <br /> Town of Sun Prairie Driveway Permit Fee: $50 <br /> Road Damage Escrow: $1500. <br /> 5556 Twin lane Road <br /> Marshall, WI 53559 Location: Cr e e /L gay h Pd 1-0 .� <br /> (o H 0 6 'e , lu! 53s,9 7 <br /> 1'4 of 1�4, Sec. 3 <br /> s � 47 <br /> Application to Permit to Construct a Driveway <br /> (Access from private property to a town road) <br /> REQUEST BY APPLICANNT <br /> Name <br /> t S/ <br /> o j1 <br /> Address / /�N of /?e A/ ad son 1/41/ 537/ <br /> Office phone.2��- 6 9/Local phone: a6a yet-X30 Fax: -- <br /> -� <br /> Plans Prepared by Zeic_ Cti ` ,7 Copy Enclosed Yes No <br /> Location of Proposed North,Sout ,East,\Vest Side of /'re e ��t Road <br /> Access: (-- �/ <br /> Section# Feet Miles from <br /> The applicant understands and agrees that the permitted work shall comply with all permit provisions and conditions <br /> listed on the reverse side hereof,any special provisions listed below or attached hereof, and any and all plans,details or <br /> notes attached hereto and made a hereof. <br /> By Title �, `` j'J/ <br /> RL tf�iJN�r_ / !/C�DrulGo� ffG�s'lrrS <br /> Signature of Applicant <br /> Date _ -� 7 <br /> Permit Conditions: Completed by Public Works personnel <br /> • Width of driveway <br /> • Center of driveway from property line: f 5 7 Rvccit/ <br /> • Drainage Culvert Needed r No Drainage Culvert Needed <br /> Size: Length: feet <br /> Diameter j inches <br /> All Culverts are to have ends <br /> Other All construction equipment must use this entrance to access lot.All Culverts must have ends <br /> Requirements: (wings).Culverts are to be completely installed prior to final inspection and approval by public <br /> works personnel. <br /> � - No construction materials are allowed in the public roadway.Dumping of landscaping <br /> materials(mulch,stone,topsoil,etc.)on the road will cancel the return of the$1,500 escrow. <br /> Estimated Starting Date <br /> Hay 7 Estimated Completion Date Sep T]! /7 <br /> t <br /> Notify the Town Office at 837-6688 when project is completed. <br /> DRWAY Permit Procedure.doc Rev 4'16,15 4 <br />