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3. In the event a culvert is required, said culvert shall be covered by sufficient material <br /> to protect it from the weight of vehicles using the access. <br /> 4. Placement and maintenance of culvert is the responsibility of the property owner. <br /> 5. All dimensions and construction of accesses will adhere to Dane County and Town of <br /> Pleasant Springs standards. <br /> 6. Nothing may be placed in the public right-of way except legally constructed <br /> mailboxes <br /> T. The Property owner is responsible for damage to road edge caused by demolition <br /> and/or construction. <br /> AKNOWLEDGEMENT: <br /> As owner of the above named property,I acknowledge and agree that I am responsible for <br /> any damage to the roadway, shoulder or right-of-way,which occurs during the emolition <br /> and/or construction process,up to and including any time period until an occupancy <br /> permit and/or final demolition inspection notice from the Town of Pleasant Springs <br /> Building Insyector is issued and received by the Town. I agree that the damage deposit of <br /> $ 1 000. o I make will be retained until the Town Board acts to release the deposit. <br /> No deposit will be returned until all inspections are complete and compliant. Costs for <br /> any damage, solely determined by the Town,will be deducted from the deposit prior to <br /> return. <br /> —1C-1X/0 110 <br /> Property Owner Signature Date <br /> Approval of initial access <br /> act /J <br /> Town Representative Date <br /> Additional Access: <br /> Access granted/denied by the Town Board on: ,20_ <br /> Reason for denial <br /> Deposit amount: - Type: X personal check <br /> money order/cashier's check <br /> Date deposit authorized to be returned by: Public Works Staff <br /> Town Board: <br /> Date deposit authorized to be held by Town Board: <br /> Date deposit returned by Clerk/Treasurer: <br /> Comments: <br /> C:\Shared\Word files ROADS\Documents\access permit revised June 2007.doc <br />