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Town of Sun Prairie Driveway Permit Fee: $50 <br /> Road Damage Escrow: $2,000. <br /> 5556 Twin lane Road <br /> Marshall, WI 53559 Location: PrOSiMe/fbr <br /> t. s_ P <br /> 1/4 of 1/4, Sec. <br /> Application to Permit to Construct a Driveway <br /> (Access from private property to a town road) <br /> REQUEST BY APPLICANT /l <br /> Name <br /> 6...em n V( a t(< <br /> Address <br /> Mehda 7> - 11 eivi 141 53q 3a <br /> Office phone Local phone: l4)_ 251)._2665Fax: <br /> Plans Prepared by l.� [ p� r� opy Enclosed )( Yes No <br /> Location of Proposed ort , South, ll.t,West Side of u J <br /> Road <br /> Access: �` <br /> Section# s/Miles from fiô' Y LA! <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 <br /> or notes attached hereto and made a part thereof <br /> � Cf-� I Title ,( T <br /> Signature of Applicant <br /> Date Lr <br /> Permit Conditions: Completed by Public Works personnel <br /> • Width of driveway /' / -2y / <br /> • Center of driveway from property line: <br /> • Drainage Culvert Needed No Drainage Culvert Needed <br /> Size: Length: / feet <br /> Diameter / inches <br /> All Culverts are to have end_ <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$2,000 escrow. <br /> The Town requires the Owner and Contractor(s)initial that they have read and understand <br /> these terms. <br /> Q9tne '(3 C <br /> I DRWAY Permit Procedure_Rev2017 Revision Approved 3/13/2017 <br /> 4 <br />