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TOWN OF CROSS PLAINS DRIVEWAY PERMIT APPLICATION <br /> DATE: 1--5- X021 <br /> I. CONTACT INFORMATION-To be Completed by Applicant: <br /> Name and current address Paiiria / fair/04 "de_ <br /> of applicant <br /> 3Z28 Ridgeway Ave , Mact,+.sr/n, i4E 5370.1 <br /> Current telephone number: work (,o8-aN3-8y/9 home (oo8 -57y (o`//(O <br /> Driveway location in Cross Plains:,S'-I-arcna"h P() Lv,Z <br /> Location: west east south north side of Sec. <br /> Parcel number: 6 707- ///- WOO -2- <br /> Contact <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 /> *******************lock************* *********************************** <br /> II. CONDITIONS-To comple d by Town Board member or its agent: <br /> Width of driveway: feet Maximum grade of 12%. <br /> Drainage culvert needed: no yes fig" itml,) .00 <br /> If culvert required, must meet Driveway Construction Guide standards. L, 1 ` • <br /> Agricultural use only: (no yes �.Q.& <br /> Shared driveway agreement required: 1Q no yesss-Afr <br /> Other requirements: <br /> 1. Shall comply with town private road ordinance and driveway construction guide for new <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 /> ********************************************* ** * BF*************** <br /> III.APPROVAL—Date Approved By Town Board: ate Issued: 5V/3 <br /> The Driveway Permit is valid for one year from date of approval. <br /> The Driveway Permit is pending recordation of the Certified Survey Map at Dane County <br /> Register of Deeds <br /> Permit: Part 1 Driveway Permit Part 2 Single Residence <br /> $400.00 Fee <br /> Reminder: Please check with Dane Co. Land and Water Resources Departme . on soil ero <br /> permits to see if required. <br /> --..wilk /pr. <br /> iv0 r.,tec2A <br />