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DATE:. 1/275108 Town Fee: i dt)• Pd <br /> own of Springfield / <br /> Driveway Permit Ck.#: <br /> Name & Address of Applicant: Driveway Location: <br /> ,8r,a.i ¢kr;s 201a142.- Road Name: R ;161 1 <br /> 76.5D ks 41, <br /> (N/S/E/W) side <br /> /!1i do - , l.J,= . s 3 51oa- t <br /> Feet (N/S/E/W) of <br /> Phone: Lot-e3/ -7,s7 Section: ct® Lot # <br /> Subdivision <br /> CONDITIONS <br /> For access from private property to a town road the permitted driveway must meet all <br /> requirements per Town Ordinance 4.18 which includes the following: <br /> Driveway Construction Plan <br /> Erosion control permit if needed <br /> V Culvert (made of corrugated metal approved end walls, if required <br /> )�with PP � uired q <br /> Sizq; . ® � y ice Arive <br /> 1e� <br /> Signed certification that applicant agrees to abide by town ordinance <br /> Applicants Signature 23:41 ) Date: <br /> V4.5-4? <br /> Permit Granted By: )237/4 Date: c) <br /> (Town of Springfield Designee <br /> (White copy - Town, Yellow - Applicant, Pink - Dane County Zoning) <br />