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TOWN OF CROSS PLAINS <br /> DANE COUNT!, WISCONSIN <br /> ' DRIVEWAY AND CULVERT APPLICATION, PERMIT AND <br /> INSPECTION FORM <br /> t , <br /> 1 <br /> PART It (Application) <br /> TO THE TOWN BOARD; The undersigned hereby applies for a permitato <br /> construct a driveway culvert in the Town of Cross Plains, ne <br /> County, Wisconsin. The driveway will be in Section 7 _ of the <br /> Town of Cross Plains off Hwy. or Town Road <br /> through the property owned by: <br /> ter, if 1 ,—ej _ <br /> Name of Property Owner 1 , _ , <br /> Signature <br /> _2.1 4 . P1N _ .g_ �.- Date Y'id-0 <br /> Mailing Address <br /> Name of Applicant fl <br /> Signature (� <br /> Date / ` <br /> Mailing Address <br /> Contractor <br /> A driveway construction plan, <br /> site plan according to Town <br /> Ordinances and control plan will be presented to the `Town <br /> Hoare icy • ,erosion <br /> ` . <br /> Does applicant desire to use material from the excavation of the <br /> house site to provid fill for the proposed driveway? <br /> If "Yes" , an excavation permit must be <br /> No obtained from Town Chairperson. ) <br /> Proposed driveway length (in feet) <br /> Application fee $ X60 <br /> Date fee received <br /> r <br />