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- __„ .....+erriccar;*•:; 3'rn;F,'�. r-sCrtkP "'�. .. _ _ ,it fi - - <br /> DATE:_if Town of Springfield Fee: / ' <br /> Driveway Permit ck.#: , 4/l ..., <br /> Name & Address of Applicant: Driveway Location: 'f r <br /> .� �C° Z,�. ;,r�4 Road Name: s <br /> (N/S/E/W) side <br /> 77144/1 ra&J : 44,1/ .!-r r‘2 <br /> Feet (N/S/E/W) of <br /> Phone: h t . = r,3/- 42'5"'2 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 /> Culvert (made of corrugated metal),with approved end walls, if required <br /> Size: <br /> Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature / Date: <br /> r <br /> 24 <br /> 1 <br /> Permit Granted By: °' "'`� :�-°' Date: 1 <br /> (Town of Springfield Designee) <br /> (White copy - Town, Yellow - Applicant, Pink - Dane County Zoning) <br />