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PAGE 2 <br /> Name of applicant of Driveway Culvert Application: <br /> C�era.t a' L F � <br /> PART II: (Permit) <br /> 1. Town Board denied driveway permit. Date: <br /> (41; permit. Date: <br /> 2 . Engineers' Plan _� d�is not required. <br /> l/is required. <br /> Date of approval by Town Board 9- ` 0 (- <br /> 3 . A culvert at the ditch line where the driveway meets the public <br /> road <br /> i�required. <br /> is not required. <br /> Signature of Town B a <br /> ard Chairperson Date <br /> PART III: (Inspection of Completed Driveway) <br /> Driveway is in accordance with plans approved by the Town <br /> Board. <br /> 'Driveway is not acceptable. <br /> Owner will make required improvements by <br /> Comments: <br /> Signature .of Town Chairperson Date <br /> NOTE: This form fully completed must be presented to the Dane <br /> r County Zoning and Natural Resources Committee before the <br /> County will issue any required building permits . <br />