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DATE: 4212-46 Town of Springfield Fee: /SO. <br /> Driveway Permit Ck. #: Cash <br /> Name & Address of Applicant: Driveway Location: <br /> 5- kDrCatil- Road Name: 0N(f" N( t= <br /> 4 >I \toYv,kwnD Utz • I,-(1r <1_' <br /> /E/W) side <br /> Feet(N/S/E/W) of <br /> Phone: 6g) _ Section Lot ti 2.4 <br /> Subdivision -VLIMh f_ ;r <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 ..121-='< t■IV-7A -wJTLcz F>� L� n-N � JT <br /> Erosion control permit if needed N(5' <br /> Culvert(made of corrugated metal), with approved end walls, if required <br /> II I <br /> Size: ��X O <br /> ✓` Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature `!—` I ( Date: Z L <br /> f M1 <br /> Permit Granted By: / ' / '/ / Date: "/L/ <br /> (Town of Springfield Designee) <br /> (White copy- Town, Yellow-Applicant, Pink-Dane County Zoning) <br />