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Town of Madison C� <br /> 2120 Fish Hatchery Rd <br /> Madison WI 53713 <br /> Ph:608-210-7260 <br /> Fax:608-210-7236 APPLICATION FOR DRIVEWAY PERMIT <br /> (Drawing must be attached in duplicate) <br /> Location- - o <br /> Co f of /Oar '<LAI 4 1" (0. Parcel Number <br /> Property Owner 044 S2,v1 ir.,r' A Af s LLC_ -7(S gq?-03b 3 <br /> Name of Company and Owner or Agent Telephone Number <br /> Job Contractor C_Cw).-- -CLA.: b-. C v►'t!?n -AZOCLG E,•1—Ac- <br /> t, <br /> C--g92 -o3k,3 <br /> Type of Driveway: (check one)Class I (residential) Class II (commercial) <br /> • Width ag Feet <br /> • 1(• . Feet from mod _ Property Line <br /> • 6 Feet from right-of-way line of intersection <br /> • (check one) Shoulder construction Raised Curb <br /> • Edge Radius feet 'TA,..p cd rev 0 �s <br /> • Angle to pavement edge (3O degrees-le-kw tck <br /> • Grade of approach 5-7 degrees i p- \2.% <br /> • Plantings on right-of-way area <br /> (Grass,flowers or low growing shrubs) <br /> (Attached drawing shall show the following:Driveway and approaches; property lines;right-of-way <br /> lines;adjacent intersecting roads,streets or railways within iou feet, width-and type uilTrad-surfauci <br /> width of right-of-way;distance from right-of-way line to gasoline pumps and other structures on site; <br /> type of surface and width of driveways;type of surface and width of approaches;proposed turning <br /> radii;proposed treatment of right-of-way area adjacent to and between approaches;rate of slope or <br /> grade of approaches and driveways.) <br /> Special provisions:Proof of public liability insurance <br /> Cut 1 Pak- 5`�� -- pz13 �v 1 ns,Eac pt'lur �o ��,+rir eA.nu' <br /> Applicant does hereby agree to conform with all requirements of Town of Madison Ordinance No.4-3-1 <br /> and 4-3-2. <br /> L . <br /> Approved _ <br /> • . . i ignature <br /> Printed Name <br /> Business��Managerr r_ q <br /> Date Y 1 Z$1 19- Fee $35.00 TRU (O9 ! I <br /> Q b/z8/r9" <br />