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iN0 ZO <br /> Driveway/Culvert Permit 7555 W. Old Sauk Road <br /> Verona, WI 53593-9700 <br /> Phone: 608-833-5887 <br /> Town of MiddletonFax: 608-833-8996 <br /> info(@town.middleton.wi.us <br /> Last Updated: 05/17/21 <br /> Part A: (To be Completed by Applicant and submitted to Town) <br /> Builder's Name: Tim O'Brien Homes <br /> Builder's Address: 2601 Crossroads Dr,Ste 140, Madison,WI 53718 <br /> Builder's Phone: 608-661-1100 Builder's Email: clevy@tobhomes.com (TOH Rep) <br /> Property Owner's Signature:CL2 <br /> 04" ./.(47, <br /> G'"J Date 06/28/21 <br /> Property Owner's Name: Tim O'Brien Homes <br /> Property Owner's Address: 2601 Crossroads Dr,Ste 140,Madison,WI 53718 • <br /> Property Owner's Phone: 608-661-1100 Property Owner's Email: clevy@tobhomes.com (TOH Rep) <br /> Lot or Parcel Description: Street Address: TBD Manistee Way <br /> Plat NameICSM/Lot Number: 65 Parcel Number:038/0708-301-0155-0 <br /> Metes and Bounds: <br /> Driveway Details: <br /> X Sketch Attached(Sketch must include the spot elevations at roadway tie in, low point of driveway, 20'from edge of <br /> pavement and proposed garage elevation. Sketch must be in plan view and show the relative location of proposed <br /> home and driveway within the property.The sketch must include driveway dimensions or have a proper scale.See <br /> example attached. <br /> Driveway Length(Measured from edge of street pavement to face of residential/commercial structure): 59'4" <br /> Check All That Apply: <br /> Driveway Enhancement(i.e.grade changes, additional pavement) <br /> X New Driveway Long and/or Shared Driveway <br /> Asphalt Surface X Concrete Surface Gravel Surface <br /> Other Information: <br /> I <br />