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00/30/1999 13: 19 6080457409 SCHMITT LAW OFFICE PAGE 02 <br /> • <br /> TOWN OF CROSS PLAINS <br /> DANE COUNTY, WISCONSIN <br /> DRIVEWAY AND CULVERT APPLICATION, PERHIT AND <br /> INSPECTION FORM <br /> PART Is (Application) <br /> TO THE TOWN BOARD; The undersigned hereby applies for a permit to <br /> construct a driveway culvert in the Town of Cross Plains, Dane <br /> County, Wisconsin. The driveway will be in Section /L of the <br /> Town of Cross Plains off Hwy. or Town Road <br /> , through the property owned by: <br /> I if ) <br /> Signature <br /> Name of Property Owner �� <br /> ,,�-'�' <br /> '; J Date i :� 5' - <br /> i.j-'�- <br /> Mailing Address <br /> r � Z <br /> Name of Applicant '( f) ; ..; <br /> L/ !� <br /> Signature ; a/ 't /,f Iv Date ! a - 5- ..e ? <br /> Mailing Address ( 5-0 7 t , to 7 <br /> Contractor <br /> A driveway construction plan, site plan according to Town <br /> Ordinances and erosion control plan will be presented to the Town <br /> Board by • - S -- a <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 "Yea" , an excavation permit must be <br /> obtained from Town Chairperson. ) <br /> Proposed driveway length (in feet) <br /> Application fee $ <br /> Date fee received <br />