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` 'mo-4O ^..tom° A: 740,000 <br /> DAT.E: /6/0q Town of Springfield Fee: .4:r6 €0 <br /> Driveway Permit <br /> Name & Address of Applicant: Driveway Location: <br /> kA r 1--A e.A 4-:,?6,f` iz Road Name: ,/1 <br /> ��tJL Oe-Ri ctiee-/6 R Cc,A 5 <br /> (N/S/E/W) side <br /> C /A/ (41.1'- <br /> . ._ =.7•■"'4i-Pl,• as w. .-Feet €hT/StEJ'w) of -....s� .« <br /> Phone: C e- 7/. - 3 -t-4/0 Section: ) Lot # / <br /> Subdivision 4A0 rz-/AA1v Pc '/) <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 /> Erosion control permit if needed ,. 4 lii, <br /> " Culvert (made of corrugated metal),with approved end walls, if required <br /> Size: /?2i `) PO -I/ 5 <br /> V" Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature �° / yJ Date: /( - 8- .760 <br /> 4 1 Permit Granted By: '1 - . <br /> �. Date: )6 , , <br /> (Town of Springfield Designee) <br /> (White copy - Town, Yellow - Applicant, Pink - Dane County Zoning) <br />