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J?/,fl e n15e//ei .2- K 3) - <br /> • <br /> Pit b I•L 1 rC'of., ,- <br /> MaSr /11 cpeer <br /> ;r k r� <br /> d , VC' W'L //Cv 15 <br /> • <br /> Town of Burke <br /> Driveway Permit Application <br /> (Access from private property to a town road) <br /> NAME OF APPLICANT: £ I S/b/(1 S" l c.:4 )4, <br /> ADDRESS OF APPLICANT: Z , <br /> SLR 1911/, / /j )/ 535 <br /> PHONE NUMBER: .S2/'— -225'15// <br /> PROPERTY OWNER: <br /> LOCATION OF PROPOSED ACCESS: p� <br /> Lot#07/ Subdivision �S /1)LLStreet / '-t- C1 S 4'555 <br /> North, South, East, West side of Road <br /> Town of Burke, Dane County, Wisconsin <br /> * * * * * * * * * * * * * * * * * * * * * * * * * <br /> PERMIT CONDITIONS <br /> (To be completed by Town Personnel) <br /> Driveway is 24 feet wide. I request a variance of feet <br /> All culverts are to be 24 feet long. Diameter is 18 inch arch with end walls (wings). <br /> { } No drainage culvert needed <br /> { } Variance from size needed. <br /> Other Requirements: <br /> All construction equipment must use this entrance to access lot. Culverts are to be <br /> completely installed prior to final inspection and approval by highway personnel. <br /> I acknowledge receipt of attached Ordinance and agree to follow all terms. <br /> Date: , 5/02&70 <br /> Applicant signature ` <br /> Permit granted: ' a j��: — Date: 1 � <br /> i • Officia Designee Signature) <br />