Laserfiche WebLink
iry <br /> 1 (� <br /> Town of;Burke <br /> Driveway Permit Application <br /> (Access from privatepropertyto a town.road) <br /> NAME OF APPLICANT: } , C W ' 4 ` <br /> ADDRESS OF APPLICANT: 4-0 1 t\ . (TA I-1.uv } <br /> \I"NI C .W UAL1 1 , 1; \N 1{. <br /> PHONE NUMBER: NO f. 1 `"E. _S,T) <br /> PROPERTY OWNER: ("fin 1/VVV)....- i)VY\tSf 4 ) A/t.i.9111/4f <br /> LOCATION OF PROPOSED ACCESS: <br /> II <br /> Lot;; Subdivision , '1070/ V-0,0 k\ Street A I V\ V I <br /> North,Sout l East,West side of 1 V\/I IV\O, DV-1 `E/�' Road <br /> Town of Burke,Dane County,Wisconsin <br /> PERiMIT CONDITIONS <br /> (To be completed by Town Personnel) <br /> Driveway is 24 feet wide. I request a variance of feet <br /> All culverts are to be 24 feet long. Diameter is 18 inch arch with end walls (wings). <br /> } No drainage culvert needed C 0-1 v---1-- i s a cLe- <br /> f} Variance from size needed. <br /> Other Requirements: <br /> All construction equipment must use this entrance to access lot. Culverts are to be <br /> completely installed prior to final inspection and approval by highway personnel. <br /> I acknowledge receipt of attached Ordinance and agree to follow all terms. <br /> Date: i(f, 11,c <br /> Applicant signature `1 ' : <br /> Permit granted: ; c 1 <br /> Date: 6h i 7 zap I <br /> (row,"OfaciallDesignee Signature) <br />