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s+ . .4• <br /> DATE: J U 1 - ► t. Town of Springfield Fee: 1 j) �' <br /> Driveway Permit Ck. #: f�,;' .)c <br /> Name & Address of Applicant: Driveway Location: <br /> It 1)/Y. . Road Name: /-TLL t Lt_o l n Puny( 1 k <br /> `c ,-i`. 1~hd`'`�� <br /> (N/S/E/W) side <br /> Feet(N/S/E/W) of <br /> Phone:L C_ f if 2 I 77 f Section .? Lot# <br /> Subdivision f\t,L I i,L,-n <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 /> Culvert(made of corrugated metal), with approved end walls, if required <br /> Size:(4) <br /> Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signatu_ Date: / 0~/ �= <br /> 414 "" :•rr <br /> Permit Granted By: if - ■ Date: <br /> (Town of Springfield Desi_ ee) <br /> (White copy- Town, Yellow-Applicant, Pink-Dane County Zoning) <br />