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Name of Applicant Derek Carpenter HDS Inc <br /> PART II: (Permit) <br /> 1. Town Board denied driveway permit. Date: /(2 1,3/7141 <br /> appr ved permit. Date: <br /> 2. Engineer's plan is not required. <br /> is required. <br /> Date of approval by Town Board /o / /6 <br /> 3. A culvert at a ditch line where the driveway meets the public <br /> road <br /> is required. <br /> is not required. <br /> 6 <br /> Signature of Town B rd Chairperson Date <br /> PART 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 of 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 />