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0a <br /> q/"'/ate: ' Town of Springfield Fee: _11 100,E <br /> DATE: �J <br /> t i_ Driveway Permit ck." 'i�qq: I` <br /> I a Driveway Location: <br /> iii Name&Address of Applicant: Y <br /> ,tou... Odstp.. ._, .ir/.' . Road Name: G/Pee.../3.t,,.rC <br /> 1 is <br /> ; N.Am.� J FnV IL Li-d-I <br /> 4,',"7' <br /> x?; 70 / KW A7 <br /> (N/S/E/W)side <br /> h Atan...tN caliz rd. Wsir eFXi9N4 J <br /> " " Feet(N/S/PJW)of <br /> -/9.+ e/i�L<a Section: 3s' Lot# /a `3 <br /> Phone:, 72_32s.6 cSM /•)SV8 <br /> tASa cup Subdivision <br /> 4,. <br /> f <br /> CONDITIONS • <br /> ;' For access from private property to a town road the permitted driveway must meet all <br /> ,,r requirements per.Town Ordinance 4.18 which includes the following: <br /> /fv/4ch'S Driveway Construction Plan <br /> AY* Erosion control permit if needed <br /> 1 with approved end walls,if required <br /> �. /../if Culvert(made of corrugatedlmetal), pp <br /> j +� <br /> i ,6 nr/g. ,A,/,fa Sa3 G'rJ ts+f <br /> 4.<,..,.....47 O0.4- Arr4.u<c/ <br /> q-rr*-0-•/ Signed certification that applicant agrees to abide by town ordinance <br /> ".;.r:`.$- '4'^---t1--d-l 4S'" 9V/3/or- <br /> 3 <br /> ''. Applicants Signature �...., �74� t"/ J'""c' G` Date: <br /> 6y• 4044-- / ys....+. r. 1...-e <br /> gl- }} <br /> Permit Granted By: '`7/)j4 G1,' Date:�— <br /> (Town of Springfield Designee) <br /> (White copy Town, Yellow-Applicant,(Plink-Dane County Zoning) <br /> 1 ( PY <br /> S } i <br />