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Town of Sun Prairie <br /> Driveway Permit Application <br /> (Access from private property to a town road) <br /> NAME OF APPLICANT: 4 ' SL vim _4 4 if <br /> ADDRESS OF APPLICANT: <br /> & ci' tt/.j- 53 5-72) <br /> PHONE NUMBER: J— '7—ciff8'7— A.3.0/"/ <br /> LOCATION OF PROPOSED ACCESS: <br /> North, South, East, eb ide of ( -0/ th,„14.1.-- Road <br /> (circle one) <br /> Located miles/feet from <br /> In Section i , Town of Sun Prairie <br /> PERMIT CONDITIONS <br /> (To be completed by Town Personnel) <br /> Width of driveway feet. Y <br /> • <br /> Center of driveway from property line: feet. <br /> [ ] No drainage culvert needed. <br /> [ ] Drainage culvert needed. Size: Length feet <br /> Diameter inches <br /> All culverts are to have ends <br /> Other Requirements: <br /> All construction equipment must use this entrance to access lot. All culverts must <br /> have ends (wings). Culverts are to be completely installed prior to final inspection and <br /> approval by highway personnel. <br /> Permit granted: <br /> t/10��.`V Date /l //fr) d <br /> n Official/Desi: e Sig ure <br />