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• <br /> • <br /> ) al41(&A/77-411--€-'t <br /> TOWN OF SPRINGDALE DRIVEWAY PERMIT APPLICATION DATE: /f✓ //�1 <br /> I. CONTACT INFORMATION - To be Completed by Applicant: <br /> Name and current address �/ V' „TPo o/c., ,�,y7a�L°17�,�,� <br /> of applicant ' /03 L(l2G�R, ,ega , f <br /> Current telephone number: work home Z-4 747 <br /> Driveway location in Springdale: 6e /e <br /> Location: west east south north side of Sec. lQ • <br /> Parcel number: a0 0 72 ap 2 -g-S-$o -V <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 /> II. CONDITIONS - To be completed by Town Board member or its agent: <br /> Width of driveway: / /vet U Maximum grade of 10%. <br /> Drainage culvert needed: no yes RECEIVED <br /> If culvert required, must meet Driveway Construction Guide standard . <br /> Agricultural use only: no yes 2008 <br /> Shared driveway agreement required: )(no yes DANE COUNTY PLANNING&DEVELOPMENT <br /> Other requirements: <br /> 1. Shall comply with town private road ordinance and driveway <br /> construction guide for new driveways. <br /> 2. Shall contact Town Patrolman Dan Chancellor at 437-3648 before <br /> starting construction of the driveway. <br /> 3. No Building Permit shall be issued until Driveway Permit Part 1 AND <br /> Part 2 has <br /> been issued. <br /> 4. lic21/1 -oc- e_e /0 5 a- Q/l*t 7i/2 7L-i/ -7e_ O <br /> /ez./l'jam <br /> ********************************************** ***************** ***** <br /> III. APPROVAL - Date Approved By Town Board- /5/ Date Issued: .S �, <br /> The Driveway Permit is valid for one year from date of approval. <br /> 71/Aie <br /> The Driveway Permit is pending recordation of the Certified Survey Map Icy <br /> at Dane County Register of Deeds <br /> Permit Part 1 -Driveway Permit Part 2 Single Residence Duplex <br /> $100.00 Fee Reminder:Dane County Erosion Control Standards may <br /> apply. <br />