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Name of Applicant 4..../9=1„-"1 ": <br /> PART XI: (Permit) <br /> 1. Town Board denied driveway permit. Date: <br /> /2-,---approved permit. Date: <br /> 2. Engineer's plan is not required. <br /> required. <br /> Date of approval by Town Board <br /> 3. A culvert at the ditch line where the driveway meets the public <br /> road <br /> /!-- is required. <br /> is not required. <br /> „--- 7- /47- <br /> Signature of Town Board Chairperson Date <br /> PART III: (Inspection of Completed Driveway) <br /> • Driveway is in accordance with plans approved by the Town Board <br /> Driveway. is not acceptable. <br /> . owner will make required improvements by <br /> . ° <br /> Comments <br /> • <br /> • <br /> Signature of Town Chairperson Date <br /> NOTE: This form fully completed must be presented to the Dane County <br /> Zoning and Natural Resources Committee before the County will <br /> issue any required building permits. <br />