Laserfiche WebLink
J <br /> TOWN OF BLUE MOUNDS • <br /> DANE COUNTY, WISCONSIN <br /> DRIVEWAY CONSTRUCTION APPLICATION, <br /> PERMIT AND INSPECTION FORM <br /> PART I: (Application) <br /> TO THE TOWN BOARD; The undersigned hereby applies for a permit to <br /> construct a driveway in the Town of Blue Mounds, Dane County, <br /> Wisconsin. The driveway will be Town Section 7 of the Tos of <br /> Blue Mounds, off Hwy 7 i or Z own Road ,>�..{E� fkr'/ <br /> , through the property owned by: <br /> // <br /> Name of Property Owner ( _i Wiz-��= � J_.__ cr.-'t:s' ��flrc l-, � • <br /> Signature c� %.6 -r c. z- , .� � Date <br /> Mailin g Address ;1 GGJ <br /> Name of Applicant <br /> Signature • Date <br /> Mailing Address <br /> Contractor <br /> A driveway construction plan and erosion control plan w .11 be <br /> presented to the Town Board by f.%,..1 t Ae.lv. <br /> Does applicant desire to use material from the excavation of the <br /> house site to provide fill for the proposed driveway? <br /> NO am.. YES (If "yes" , an excavation permit must <br /> be obtained from- Town Chairperson. <br /> Proposed driveway length (in feet) f`Cl <br /> Application fee $ ,�t2p, 0(.2 <br /> Date fee received <br /> (over) <br /> • <br />