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TOWN OF SPRINGDALE DRIVEWAY PERMIT APPLICATION DATE: ■ 00g <br /> I. CONTACT INFORMATION - To be Completed by Applicant: <br /> Name and current address /d-r <br /> of applicant U <br /> 69 7//lh0C St k /14CG,, /27---5 37-W <br /> Current telephone number: work / 7- / 3 home <br /> Driveway location in Springdale: C✓/G /&/'G4-4l <br /> Location: west )(east south north side of , 4 A-�l Sec. _ <br /> Parcel number: <br /> 60 -. 4 2-6-066- ..2, C4 -2 6 Q 14e GO-c/a G6c-1z .--moo,' ' <br /> bbc7-- .203-kero/O - <br /> Contact Ed Eloranta, Town Chairman, #437-4692, to arrange a site visit. <br /> Please attach a drawing of the driveway location discussed at the site <br /> visit and return to the Town of Springdale, 2379 Town Hall Rd. , Mt. <br /> - Horeb, WI 53572 as soon as possible after the site visit. <br /> II. CONDITIONS - To be completed by Town Board member or its agent: <br /> Width of driveway: 644, feet t ximum grade of 10%. <br /> Drainage culvert needed: X no yes le:1 <br /> r-9 <br /> If culvert required, must meet Driveway Construction Guidge ds. <br /> `` , `3 <br /> Agricultural use only: xno yes 0 `L Qti���� <br /> Shared driveway agreement required: /\ no yes ° v <br /> Q�p,N�a\NG <br /> er requirements: ��� <br /> / 1./Shall comply with town private road ordinance and drive , <br /> construction guide for new driveways. <br /> Shall contact Town Patrolman Devin Dahlk at 437-3648 before starting <br /> construction of the driveway. <br /> 3. No Building Permit shall be issued until Driveway Permit Part 1 AND <br /> Part 2 has been issued. <br /> 4. DIVIteAX/X,42/i)U_LeAldt../ Aa-14,- /.., --- 601-11.1e/X-E-Uf.,, LeYtZle-pf- <br /> ' .14.-4,(7/19e09-0//A51,/d. <br /> III. APPROVAL - Date Approved By Town Board:G Issued: /1,29,/}GC)y <br /> // /?-/„1468 G�'0t i/ /at <br /> The Driveway Permit is valid for one year fro date of appro al. <br /> The Driveway Permit is pending recordation of the Certified Survey Map <br /> at Dane County Register of Deeds <br /> ermit Part 1 Driveway Permit Part 2 Single Residenc? Duplex <br /> $1 . ee Reminder:Dane County Erosion Control Standards may <br /> apply. <br />