Laserfiche WebLink
TOWN OF DUNN PARCEL #: 28-0610- .35 _ J 9D <br /> DRIVEWAY CONSTRUCTION PERMIT APPLICATION PERMIT #: ..I %/p <br /> SECTION 1- SITE VERIFICATION <br /> ,1 L ,LS <br /> Applicant Name: Al/"� A j' �-� Date: r.�' ti <br /> Address: L�? A.) ( T `1 Tr 1 f (.-�G t/ uC L•- Phone#: <br /> J_J..i <br /> Purpose: ,Residential ❑ Field Road Access _ er <br /> ////// (Bldg. site verification not required) <br /> Property Owner's Name: 1)J -)J - 1 A) Uri') 14 �„�' d 1\J <br /> Proposed Driveway Location: / �,4 } <br /> Driveway will provide access to: ❑ US/Co. Hwy Permit# Town Rd. ❑ Private Rd. <br /> Does property owner own proposed driveway road frontage? ❑ yes ❑ no (If.no, attach copy of easement.) <br /> Bldg.Site Verification Date 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 /> ❑ Property slopes. ❑ Copy of any required Dane Co. erosion control plan. <br /> ❑ Driveway slope. ❑ Other <br /> ❑ Driveway turnaround. <br /> ❑ Location& structure of retaining walls. <br /> ❑ Length, width&radius of driveway curves. <br /> ❑ Driveway cross section showing depth& fill material. J pact s <br /> XDrainage culvert, ft. length, 'in. diameter.(Lus4h e r c! t r_)cc ( ( <br /> ❑ Driveway relationship to property lines, structures&roads. Center of driveway feet from <br /> The undersigned applicant as owner,or as owner's agent, does hereby attest that all the information provided is true and <br /> accurate and does hereby agree to construct t d scribed work in accordance with the plans and specifications filed. <br /> try !/l Cam"' <br /> Signature of Applican, Date' <br /> Public Works Foreman Initial Construction Approval Date Permit Issued Permit Fee <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 />