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Name of Applicant - -- (�� ,yz l'C;a [,= <br /> BART II: (permit) <br /> 1. Town Board denied driveway permit. Date: <br /> 1.//' approved permit. Date: 3/7,4717f <br /> 2. Engineers plan is not required. <br /> is required. <br /> Date of approval by Town Board '3/ <br /> 3. A culvert at th <br /> itch line where the driveway meets the public <br /> road <br /> is required. <br /> is not required. ' <br /> S qfa ure of Town B d Chairperson Da /0 <br /> pAR2 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 /> Comments <br /> Signature or 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 />