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4. If a Property owner violates the Driveway Concrete Setback and a Town roadway <br /> improvement project results in a change of grade between the Town roadway and the <br /> driveway at issue, Property owner waives all claims under Wis. Stat. § 32.18 and <br /> further agrees Property owner shall be responsible for all costs associated with <br /> equalizing the grade. <br /> 5. Access base shall be in place prior to the start of construction and all vehicles entering <br /> the property shall use the access to protect the roadway edge. <br /> 6. In the event a culvert is required, said culvert shall be covered by sufficient material to <br /> protect it from the weight of vehicles using the access. <br /> 7. Placement and maintenance of culvert is the responsibility of the property owner. <br /> 8. Nothing may be placed in the public right-of way except legally constructed <br /> Mailboxes. <br /> 9. The Property owner is responsible for damage to road edge caused by construction. <br /> AKNOWLEDGEMENT: <br /> As owner of the above named property I agree to all terms, conditions, and specifications <br /> outlined in the above permit and in the Town of Albion's Driveway and Culverts Ordinance. I <br /> also acknowledge and agree that I am responsible for any damage to the roadway, shoulder or <br /> right-of-way, which occurs during the construction process, up to and including any time period <br /> until an occupancy permit and/or final inspection notice from the Town of Albion Building <br /> Inspector is issued and received by the Town. I agree that the damage deposit of$1000.00 I <br /> make will be retained until the Town Board acts to release the deposit. Costs for any damage, <br /> solely determined by the Town, will be deducted from the deposit prior to return. <br /> �/4 / <br /> Property Owner Signature Date <br /> Approval of initial access J4— l0//L0 S <br /> Town Representative Date <br /> Access granted/denied by the Town Board on: , 20_ <br /> Reason for denial <br /> Deposit amount: Type: personal check <br /> money order/cashier's check <br /> Date deposit authorized to be returned by: Public Works Staff: <br /> Town Board: <br /> Date deposit authorized to be held by Town Board: <br /> Date deposit returned by Clerk/Treasurer: <br /> Comments: <br /> C:\Users\Albion\Documents\DRIVEWAY APPLICATION&PERMIT.docx 3 <br /> 4/24/06 <br />