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r <br /> Town of Sun Prairie <br /> Driveway Permit Application <br /> (Access from private property to a town road) <br /> NAME OF APPLICANT: 4/C1&..."-t.1 tT a 130 5 6 ex/ <br /> ADDRESS OF APPLICANT: /5167 ji ST <br /> Cva--9,5S l ,v S U);. St <br /> 5 6,21 <br /> PHONE NUMBER: <br /> LOCATION OF PROPOSED ACCESS: <br /> North, South, east West side of J, -6, fv'/2& Road <br /> (circle one) <br /> Located 90 /S,mile 1 + from C,j,, H. 1'7- /1 <br /> In Section p2 , Town of Sun Prairie <br /> PERMIT CONDITIONS <br /> (To be completed by Town Personnel) <br /> Width of driveway feet. <br /> Center of driveway from property line: feet. <br /> [ ] No drainage culvert needed. <br /> [ ] Drainage culvert needed. Size: Length feet <br /> Diameter inches <br /> All culverts are to have ends <br /> Other Requirements: <br /> All construction equipment must use this entrance to access lot. All culverts must <br /> have ends (wings). Culverts are to be completely installed prior to final inspection and <br /> approval by highway personnel. <br /> Permit granted: _ /'. 1 _ j r`!,.010.6 Date [214. °E <br /> own i ff cial/D-: - <br /> S ignat <br />