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.4 <br /> TOWN OF SPRINGDALE DRIVEWAY PERMIT APPLICATION DATE:3P-OS' <br /> I. CONTACT INFORMATION - To be /Completed by Applicant: /� <br /> Name and current address Y� 1 -�'� °y i' 1e. (3-r ,en 1-LC <br /> /y� y� <br /> of applicant j�` -7 te4-- % / aral f e �`4 n./ <br /> �l S ot.� �J�2z-.1 'T / Q%���IPa.ae o't C <br /> 3--3 t/$ <br /> Current telephone number: work $l- 6- /07-7.0 home 8" G/ <br /> $ -<o/,)_, G�t <br /> Driveway location in Springdale: 0.477/,'?sec.Location: west )(east south north side of 0.47 /fSec. / <br /> Parcel number: ®G d 4. 09 /S S 7/D <br /> Contact Ed Eloranta, Town Chairman, #437-4692, to arrange a site visit. <br /> Please attach a drawing of the driveway location discussed at the site <br /> visit and return to the Town of Springdale, 2379 Town Hall Rd. , Mt. . <br /> Horeb, WI 53572 as soon as possible after the site visit. <br /> *********************************************************************** <br /> II. CONDITIONS - To be completed by Town Board member or its agent: • <br /> I? /. / <br /> Width of driveway: //�/ eet Maximum grade of 10%. <br /> Drainage culvert needed: no yes Va <br /> � <br /> If culvert required, must meet Driveway Construction Guide ll dards. �m6 <br /> Agricultural use only: X no yes 0 1 <br /> J bd <br /> Shared driveway agreement required: no X yes /Gc/# 10°S <br /> Other requirements: A10 <br /> 0 Shall comply with town private road ordinance and driveway <br /> �construction guide for new driveways. <br /> / Zj Shall contact Town Patrolman Dan Chancellor at 437-3648 before <br /> starting construction of the driveway. <br /> 0 No Building Permit shall be issued until Driveway Permit Part 1 AND <br /> Part 2 has been issued. <br /> 4. <br /> ********************************************** ********************fir*** <br /> III. APPROVAL - Date Approved By Town Board: / Date Issued: /J <br /> The Driveway Permit is valid for one year from date of approval. <br /> The Driveway Permit is pending recordation of the Certified Survey Map <br /> at Dane County Register of Deeds <br /> Permit Part 1 Driveway Permit Part 2 Single Residence Duplex <br /> $100.00 FeeV/ Reminder:Dane County Erosion Control Standards may <br /> apply. <br />