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I. - } ..,,tt <br /> ('v <br /> DATE: Town of Springfield Fee: /_:/' --- <br /> Driveway Permit --j,r , :' ck.#: /(o cl'9 / <br /> Name & Address of Applicant: Driveway Location: <br /> ai'if iii:`. Irr. ' Road Name: Wr ►� � Le_ 5 C,C <br /> 1 <br /> (N/SA) side <br /> %27 /4-iaj- "- 1,1 _ 1/,'/ 130;f)z - <br /> ,413 ,/j t (PIT S <br /> Feet /E/W) of <br /> Phone: 79I— 2 799 Section: 3 / Lot # J e <br /> I / <br /> Subdivision . ,!% r� <br /> CONDITIONS <br /> For access from private property to a town road the permitted driveway must meet all <br /> requirements per Town Ordinance 4.18 which includes the following: <br /> ' Driveway Construction Plan <br /> "'"- °' Erosion control permit if needed <br /> VCulvert (made of corrugated metal),with approved end walls, if required <br /> Size: ,/�'j L ., ' V.•& *• Ri 4 14 <br /> VSigned certification that applicant g pp cant agrees to abide by town ordinance <br /> tz <br /> Applicants Signature Date: -; 2'-C <br /> Permit Granted By: <br /> I ' Date: 51)// 9 <br /> (Town of Springfield Designee) <br /> (White copy - Town, Yellow - Applicant, Pink - Dane County Zoning) <br />