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FROM 7 PHONE NO. Oct. 27 2009 03:43PM P2 <br /> 7 ) 7 4' S. ,) i i . r .•;)AX II"-4- ' <br /> //)I , D if, ite.(:,,c,.2z*i'DA/1 iqu--',--ol <br /> DATE: <br /> TO off' S?RTNGDALE DRIVEWAY PERMIT APPLICATION <br /> W, <br /> Complete <br /> by ApPl,LOAnt, <br /> T. CONTACT INFORMATION - To be p ,/ <br /> and current a�dro,a 0 � rsD�j <br /> 'Name .� <br /> of applicant -!l / G' " ' _ A'/w4 k <br /> ork 3 ' 5 // home zi3 _�' -- .. 6/ 37- �// <br /> Current telephone number: work________ <br /> l. <br /> Driveway location in Springdale: / /7 <br /> j, south north side of C771\-1 Sec. <br /> souoCatiOn= west eaSt _' <br /> OW 7- /Pi- ei7,1.ci-az. 0 07 - i/y -goo-y <br /> Parcel number: <br /> Town Chairman, #437-4692, to arrange a site visit. <br /> Contact Ed aara, location discussed at the site <br /> Please atttach h d s- <br /> a rawng of the driveway <br /> visit and return to the Town of Springdale, 2379 Town Hall Rd. , Mt. <br /> Horeb, WI 53572 as soon as possible after the site visit- <br /> II. CONDITIONS - To completed by Town Board member or its agent !� D <br /> It/ d/Lc. 1,-' �� l G <br /> Width of driveway: / > feet" x��rade of 1045. /y/ ;Uey., <br /> • 7 --LA, L�Zt qtr+. C' <br /> Drainage culvert needed= not ys$ L <br /> If culvert required, m t meet Driveway'onstruct On Cuide standards. <br /> Agricultural use only: / no yes <br /> Shared driveway agreement required: no X yes <br /> Other requirements: <br /> 1. Shall comply with town private road ordinance and driveway <br /> construction guide for new driveways. <br /> 2. Shall contact Town Patrolman Devin Dahlk at 437-3548 before starting <br /> construction of the driveway. <br /> 3. No Building Permit shall be issued until Driveway Permit Part 1 AND <br /> Part 2 has been issued. <br /> 4 <br /> ********************************************p* *** ********************* <br /> III. APPROVAL - Date Approved By Town Board:/ D&te Issued: /a- 39y <br /> The Driveway Permit is valid for one year from da a of approval. f/ %1 6'c.-rl1.. <br /> The Driveway Permit is pending recordation of the Certified Survey Map <br /> at D Register of Deeds,,.-. -_ •T-__.__ _ <br /> P rmi mart 1 Driveway Permit Part 2 Single Resideno Duplex <br /> $100-00 Fee_Reminder:Danes County Erosion Control Standards may , <br /> apply. <br />