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TOWN OF DEERFIELD <br /> DRIVEWAY PERMIT <br /> (For access from private property to a town road) <br /> Name and address <br /> of applicant <br /> QQj)cj, ) 6Pr'C. <br /> 09 <br /> ary)hr ) (A_ ,ri <br /> Phone I 614Z (O.a Ot)ii 9 <br /> Location: -:JC(/ 4‘) side of i (1 (ci/ll & C?(2" <br /> located )c -. miles/ from U I k i G f 1 U / iT) <br /> in Section 33 , Town of T<' 'i--rt e9/,,'/ <br /> CONDITIONS <br /> Width of driveway: feet. <br /> Center of driveway from property line: feet. <br /> C ] No drainage culvert needed. <br /> [ ] Drainage culvert needed Size: Length feet <br /> Diameter inches. <br /> Other requirements: <br /> Permit granted: %, 4.., 6e/ Date <br /> Town of: r4/ Pa <br /> [White copy-Town; Yellow copy-applicant; Pink copy-Dane County Zoning] <br />