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TOWN OF PRIMROSE <br /> DRIVEWAY PERMIT APPLICATION <br /> (DANE COUNTY ZONING PERMIT ISSUED ONLY AFTER FINAL INSPECTION BY THE TOWN BOARD) <br /> APPLICATION DATE: S I S <br /> APPLICANT NAME: A 11) I AEI — [^O(� TC`V C'_ 5 t O/V /‘ <br /> APPLICANT ADDRESS: ?o —60X tha. ' I/i,IL 6 r 71.1 YL 1 . 5 3 S 15 <br /> PHONE NUMBER: (Dog,aaa'-s LI '1 <br /> LOCATION OF DRIVEWAY: It l LA 1-:--c.)I) Eric gel, tiT Sl J t <br /> Applicant agrees with the following requirements of the Town of Primrose Driveway Ordinance and <br /> application. <br /> APPLICANTS SIGNATURE: 0...1•60\t,t./•-11--------- <br /> 1. Payment of required Driveway Fee of$250.00 Payable to the Town of Primrose <br /> 2. Payment of required Driveway Bond Fee of$500.00 that is refundable upon completion and <br /> approved inspection of the Driveway. <br /> (refund is made assuming no damage is done to the Highway fronting the drive) <br /> 3. Erosion Control Plan (during construction) must be in writing and given to the Town <br /> Required YES NO <br /> )( <br /> 4. Engineering Plan (prior to construction) must be in writing and given to the Town <br /> Required YES NO X <br /> 1i//h 5. Specifications of the Driveway Construction, as denoted in the Driveway Ordinance if Waived,which <br /> "I items of(a)through (p). , , <br /> The above application is hereby approved by: x Z04 . f . l / <br /> Tow Chairman O <br /> Dated this 7 day of /4/6,. x <br /> Year of oho t� Su ervisor <br /> x <br /> Supervisor <br /> Town Board Inspection of Completed Driveway <br /> 1. Driveway is constructed in accordance with the applicant's plans that were approved by the <br /> Town Board. <br /> YES NO <br /> 2. Any corrections in the construction of the Driveway must be completed by: / / . <br /> APPROVED:x x <br /> Town Chairman Supervisor <br /> DATED THIS DAY OF , <br /> TO DANE COUNTY ZONING: ZONING PERMIT MUST NOT BE ISSUED UNLESS SIGNED BY TOWN <br /> CHAIRPERSON AND SUPERVISOR ABOVE. <br />