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TOWN OF DUNN PARCEL #: 28.0610- Z53- 3z —p <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: Q_5/ <br /> SECTION 1- SITE VERIFICATION <br /> Applicant Name: Eric Vieth Date: Sit?3 117 <br /> PP <br /> Address: 3430 Quam Drive Phone#: 608-347-5121 <br /> Purpose: ® Residential 1-1 Field Road Access L) Other <br /> (Bldg.site verification not required) <br /> Property Owner's Name: Eric Vieth <br /> Proposed Driveway Location:_See attached Plan <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# XI Town Rd. El Private Rd. <br /> Does property owner own proposed driveway road frontage?1 yes ❑ no (If no, attach copy of easement.) <br /> Bldg.Site Verification Date I Comments <br /> SECTION 2 -SUBMITTAL REQUIREMENTS& CONSTRUCTION COMMENCEMENT APPROVAL <br /> Driveway Construction Permit Application must include the following checked information: <br /> Diagram Showing: Other: <br /> XI Property slopes. _ 14 Copy of any required Dane Co. erosion control plan. <br /> Xi 'Driveway slope. ❑ Other — <br /> Ll Driveway turnaround. N/A <br /> 21 Location&structure of retaining walls. <br /> ❑ Length, width&radius of driveway curves. N/A <br /> Driveway cross section showing depth& fill material. <br /> ❑ Drainage culvert, ft.length,, in. diameter. N/A <br /> 11 'Driveway relationship to property lines,structures &roads. Center of driveway feet from <br /> The undersigned applicant as owner,or as owners agent,does hereby attest that all the information provided is true and <br /> accurate and does hereby agree to construct the described work in accordance with the plans and specifications flied. <br /> Signature of Applicant Date <br /> Public yorks ,orem -4niti Construction Approval Date Permit Issued Permit Fee <br /> c�7c �J� 17 $ ono. A© <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 /> ❑ 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 /> 6 G'�,t'N --r- <br />