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DATE: Town of Springfield Fee: f 2d. <br /> Driveway Permit Ck. #: <br /> Name & Address of Applicant: Driveway Location: <br /> HULJO,V69Road Name: lici/tvty 0-7 "te' <br /> (N/S/E/W) side <br /> ( Y <br /> Feet(N/S/E/W) of <br /> Phone:LO o ' S a-o Section Lot# <br /> Subdivision <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 <br /> v Culvert(made of corrugated metal), with approved end walls, if required <br /> Size:(Y) 111,` A.1 // <br /> Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature Date: f/43h! <br /> Permit Granted By: I Date: TJ J i i <br /> (Town of S rin feel esignee) <br /> • P / <br /> ( P g � ) <br /> C , 1 <br /> (White - , , Yellow- . p icant, Pink-Dane County Zoning) <br /> (----\-10 I <br /> ,,� � 3C -2 <br />