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tiDATE:1 L`,' .1-76 <br /> I.CONTACT INFORMJ.Tk,O -yo IN Completed Applicant: <br /> Name and current address M tC Flak'''. kuile,r <br /> of applicant -.,_ `2 <br /> Current telephone number:work homei b(J s ) IL). ':'� <br /> •Driveway location in Cross Plains:"- 1e 111 Qc f <br /> Location: west e t south north side of Sec. <br /> Parcel number: ' 4. - 922p--(7) ,f-j) 02.616101-143- '1105-( <br /> Contact Town Chairman,#798-0189,to arrange a site visit. <br /> Please attach a drawing of the driveway location discussed at the site visit and return to the Town <br /> of Cross Plains,3734 County Road P,Cross Plains,WI 53528,Phone (608)798-0189 <br /> as soon as possible after the site visit. <br /> IL CONDITIONS-To be completed by Town Board member or its agent: <br /> -. *0 <br /> Width of driveway: _feet Maximum grade of 12%. ,ii 1 �; <br /> Drainage culvert needed. no yes �� ': 11 1111k <br /> If culvert required,must meet Driveway Construction Guide standards. <br /> Agricultural use only:_.....no yes ((((�"`""' <br /> Shared driveway agreement required: no es ��i <br /> Other requirements: <br /> 1.Shall comply with town private road ordina ce and driveway construction guide for new dr <br /> driveways. <br /> 2.Shall contact Town Patrolman before starting construction of the driveway. <br /> 3.No Town Building Permit or Dane County Zoning Permit shall be issued until Driveway <br /> Permit Part 1 AND Part 2 has been issued. <br /> 4. <br /> *************************************************k** ************** *** . <br /> III.APPROVAL—Date Approved By Town Board D to Issued: * �� V ��O <br /> J vo A <br /> The Driveway Permit is valid for one year from date of appr val. <br /> The Driveway Permit is pending recordation of the Certified Survey Map at Dane Coun * <br /> Register of Deeds <br /> Permit: Part 1 Driveway Permit Part 2 Single Residence A <br /> $200.00 Fee / G�a ��'''P OIL/ 't► <br /> l <br /> Reminder:Dane County Erasion Control Standards may apply. <br />