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TOWN OF DUNN PARCEL #: 28-0610-/0 3-- 23). '/-0 <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: /b5'7, <br /> l '' SECTION 1-SITE VERIFICATION <br /> Applicant Name: _ Jer6 V'y%i);a /e/Ice,-)i.-) Date: 02-."05/'.0-CY'o <br /> Address: r---jf1e>/ al. • /ac.'-3- 4-71,ad for / C 5"7 /O z°1Phone#: (9/' 35.'3-0/J7 <br /> Purpose: XResidential 0 Field Road Access ❑ Other <br /> (Bldg.site verification not required) <br /> Property Owner's Name: _rte ri"�f /- V':"% /7, a /c" .-,,)ear.i <br /> Proposed Driveway Location: (,j, L(. n'eV\k2V e.k \S' *v\ we-sfi <br /> Driveway will provide access to: 0 US/Co. Hwy Permit# Al Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? yes ❑ no (If no, attach copy of easement.) <br /> Bldg Si Verification Pa Comments <br /> . l/, (0 <br /> Srk Pty+ C - - TO -3*/4 . <br /> )( SECTION 2-SUBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Di uam Showing: Other: <br /> �U P roperty slopes. ❑ Copy of any required Dane Co.erosion control plan. <br /> I� veway slope. ❑ Other <br /> EJ Driveway turnaround. <br /> I <br /> ❑ Location&structure of retaining walls. <br /> ❑ Length,width&radius of driveway curves. <br /> 0 Driveway cross section showing p de th& fill material. <br /> Drainage culvert, ft. length, I in. diameter. 14I Cilk��' • <br /> Driveway relationship to property lines,structures&roads.Center of driveway I.S feet from <br /> (...)e -1---- p-ca\--)° (t ll■.Q <br /> The uncle.- ! ed applicant as o •r,or as owner's agent,does hereby attest that all the information provided is true and <br /> accurat: . • do-7 or:• agi construct the described work in accordance with the plans and specifications filed. <br /> Si_' lure of Applicant Date <br /> i <br /> Public ' orks F., : . Initial .,• • j.on Approval Date Permit Issued Permit Fes <br /> 0/"! a 3-i✓ --4 $ 1 bC r <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 road is authorized for agricultural use. <br /> 0 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 /> /Iz;c0,;. 3/"/0 e2.0/A, <br />