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TOWN OF COTTAGE GROVE <br /> DRIVEWAY PERMIT <br /> (For access from private property to a town road) <br /> Name and address <br /> of applicant ,. -r) -rc <br /> iLL112.fa ) <br /> A )247 fee- C5' <br /> Phone <br /> Location: aide of <br /> located miles/feet from 19 66, -4jAlr ,1- <br /> I / <br /> in Section -,2 (/7 Town Of I . #-t <br /> 4 <br /> CONDITIONS <br /> Width of driveway: feet. <br /> Center of driveway from property line: feet. <br /> ( ) No drainage culvert needed. <br /> Vi Drainage culvert needed Size: Length 4 feet <br /> Diameter <br /> inches. <br /> Other requirements: <br /> C <br /> Permit granted: , 1:.\ -yry4 Date <br /> („1 <br /> Town of 1 \,,,n---4'W-f-r--r (im <br /> -L., <br /> [White copy-Town; Yellow coy-applicant; Pink copy-Dane County Zoning] <br />