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Dane County Department of Public Works, Highway and Transportation <br /> CONTROLLED ACCESS PERMIT <br /> seos <br /> This permit is required and shall be issued in accordance with the provisions of Section 83.027 of the Wisconsin Statutes and Chapter 79 of the Dane <br /> County Code of Ordinances. <br /> Name Co.Trunk Hwy in which access is requested: <br /> Brandon Getchel PB <br /> Street Address Town,Village,City Section <br /> 1612 Lakeview Drive Town of Verona 26 <br /> City State Zip <br /> Darien IL 60561 <br /> Home Phone Work Phone Fax Number E-Mail Address <br /> (608) 921-9985 brandon.getchel@gmail.com <br /> Existing Access? If yes, how modified? <br /> Yes ❑ Relocated ❑ Removed El Change of Use ❑ Culvert Replace ❑ Asphalt Paving <br /> Describe Use: <br /> additional driveway access off of existing drive <br /> North/South/East/West Side Nearest Cross Road Distance&Direction of nearest cross rd Existing Zoning: Meets Intended Use? <br /> west CTH M 1/2 mile north RH2, B1 0 Yes ❑ No <br /> Type of Permit Requested: <br /> ❑ $110 Temporary Controlled Access ❑ $75 Temporary Non-Controlled Access <br /> ❑ $110 Agricultural Controlled Access ❑ $75 Agricultural Non-Controlled Access <br /> ❑ $110 Residential (single family) Controlled Access ❑ $75 Residential (single family) Non-Controlled Access <br /> fi $220 Residential,Joint Access> 1 parcel ❑ $220 Commercial, <100 ADT** <br /> ❑ $1,100 Private/Public, New/Existing,Street or Road ❑ $550 Commercial, >100 and<1,000 ADT <br /> ❑ $45 Miscellaneous ❑ $1,100 Commercial,>1,000 ADT <br /> **ADT denotes Average Daily Traffic. Data substantiating ADT for access or road intersections may be required. <br /> Fees paid in full on 07/27/2017 <br /> PERMIT APPROVAL BY DANE COUNTY COUNTY PERMIT NO. 17C006 <br /> The application submitted is hereby approved and this permit is issued by Dane County subject to full compliance by the Applicant with all provisions <br /> and conditions stated herein and on the reverse side hereof and all attachments hereto. <br /> Other Special Provisions: <br /> This permit is contingent on all other Local,State and/or County Agency permits,zoning and approvals and applicant must <br /> comply with all federal,state and local laws, ordinances and regulations. No concrete pavement or pavers allowed in the <br /> Highway Right-of-Way. No culvert required. <br /> Check#1090 <br /> I <br /> 08/09/2017 <br /> By © a Date <br /> Signat re of Dane County Representative <br /> Kristine Walker Associate Highway Engineer a-Q.(*) 3 I L <br /> Name and Title Phone <br /> Page 1 of 2 <br />