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S <br /> • <br /> • <br /> Town ofD 'k- <br /> (Phones 873*' <br /> Culvert and Dr iveway rNui eniectts'necessary be= <br /> the Building lnsyector wll a a building Permit. <br /> :•• <br /> (name) ,4.1._f 'on /e4, tey-5 <br /> (street address) cj ,42 I i a ,nr <br /> (location of driveway) k'c,.CZ c)/' e2n <br /> Ad <br /> Ail of the following items must be completed before a building permit can be issued: <br /> • <br /> • <br /> • <br /> J1pt��, <br /> v l! <br /> Culvert size required: /✓ X SZ�( %,' 't- cal ci l ,9 1 f <br /> • <br /> Any other special requirements: • <br /> zam CO4A. Soct•etx. f..>■/1 6e- <br /> Ce5crt5; ; .Q h <br /> M <br /> I. <br /> Inspected by Aar . .Date: q-/ /3 <br /> Property Ownct/[tcpresetttative Signature:,.,_,, <br />