Laserfiche WebLink
• <br /> TOWN OF BLUE MOUNDS • <br /> DANE COUNTY, WISCONSIN <br /> • <br /> DRIVEWAY CONSTRUCTION APPLICATION, <br /> PERMIT AND INSPECTION FORM <br /> PART I: (Application) <br /> TO THE TOWN BOARD; The undersigned hereby applies for a permit to <br /> construct a driveway in the Town of Blue Mouns, Dane County, <br /> Wisconsin. The driveway will be in Section Z -9f e Town of <br /> Blue Mounds, off Hwy or Town Road m ��b\Nti" • <br /> , through the property owned by: <br /> Name of Property Owner Y. E- (' kLtLI 46di011/1 ' <br /> Signature Date. 5I�l0 <br /> Mailing Address l i4 L !?Ja)IJ nDP 6?61 <br /> • <br /> l� � , <br /> Name of Applicant .', rAl e 0 <br /> �/ <br /> Signature a'�'� � ��/1 Mr Date 'J <br /> Mailing Address Ii 7 1`1 1&'I IYru <br /> inboRk,N1 535 <br /> Contractor <br /> A driveway construction plan and erosion control plan will be <br /> presented to the Town Board by <br /> Does applicant desire to use material from the excavation of the <br /> house site to provide fill for the proposed driveway? <br /> NO YES (If "yes" , an excavation permit must <br /> be obtained from Town Chairperson . <br /> Proposed driveway length (in feet) � /� > 2-09 <br /> • <br /> Application fee $ <br /> Date fee received 11/1ff <br /> (over) <br />