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DATE: 7 7 tS Town of Springfield Fee: / ,f7 <br /> Driveway Permit Ck. #: ,?4 ) 9-4 <br /> Name & Address of Applicant: Driveway Location: <br /> t J.M'fla&J t4&,jaz-- Road Name: 1-leAter* y Porn 1'a <br /> (/S/E/W) side <br /> 1nti, c -i r to I 1 _ (e26 <br /> Feet(N/S/E/W) of <br /> Phone: 4:19 --1243 Section Lot# <br /> Subdivision 3-14vencrvu y Pao <br /> CONDITIONS: <br /> For access from private property to a town road the permitted driveway must meet all <br /> requirements per Town Ordinance 4.18 which includes the following: <br /> Driveway Construction Plan <br /> t / Erosion control permit if needed ' <br /> V Culvert (made of corrugated metal), approved end walls, if required <br /> ( g ), PP , q <br /> Size:,) L )1 3 <br /> Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature „�L Date: LS <br /> Permit Granted By: Date: 2 /. <br /> (Town of Springfield Designee) <br /> (White copy-Town, Yellow-Applicant, Pink-Dane County Zoning) <br />