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TOWN OF 7669 County Highway PD Verona, WI 53593 <br /> V E R N A' 845-7187, Fax 845-7143 www.town.verona.wi.us <br /> Driveway Construction Permit Location: Lot 3 CSM 15213 Spring Rose Rd. <br /> Date: May 26, 2021 <br /> Applicant/Agent: <br /> Property Owner: James And Lacy Jafola <br /> Mailing Address for Completed Permits: <br /> Name: Phil Domash <br /> Address: 640 Logan Circle <br /> Marshall, WI. 53559 <br /> Parcel # 0 608 312 8750 0 <br /> Town Road: Spring Rose Road <br /> Permitted Use: /Residential driveway <br /> Public Works Determination: Date: 5/25121 <br /> Prepared by: WCB <br /> Determination: <br /> • Driveway approval is contingent on the submission of a Dane County Soil Erosion Control Plan <br /> • Drive shall be constructed in accordance with the approved plans. <br /> • Culvert to be installed shall be corrugated metal pipe (CMP) with steel end walls, 15" dia. <br /> • Driveway to be cleared 22 feet wide by 16 height for emergency vehicles <br /> • Roadside vegetation shall be cleared to provide 350 feet of clear vision triangle for the driveway exit <br /> • Restoration shall be completed prior to one year expiration date — 5/26/22 <br /> Verona Fire Department Date: <br /> Prepared by: E-mail: mmiller@veronafire.ci <br /> Determination: N/A <br /> Applicant has been approved for a single-family residential driveway construction permit at Lot 3 CSM <br /> 15213 as approved by the Town of Verona Public Works Committee on 5/25/21 <br /> 5[Z0.21 <br /> 6 <br /> Town Chair or Designee } <br /> Date <br /> Page 2 of 2 <br />