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CHRISTIANA TOWNSHIP <br /> DRIVEWAY/ACCESS PERMIT <br /> APPLICANT PERMIT# 110 <br /> Name: Gerald Scott Polster Phone: 334-8803 <br /> Address: N4676 Old Forest Dr. <br /> Cambridge, WI 53523 <br /> Parcel: Lot 2 <br /> LOCATION: South side of County Highway B, approximately .30 miles west of <br /> Clearview Road in the N W 1/4 of the NE 1/4 of Section 27. <br /> REQUIREMENTS: <br /> Owner shall abide by Ordinance#200. <br /> Owner will need a permit from Dane County Highway Department. <br /> VARIANCES: <br /> None <br /> CONDITIONS: <br /> This permit is void one year after the date it is issued. If construction is not <br /> completed at that time,the applicant is responsible for obtaining a new permit. <br /> It is further understood and agreed that the applicant shall indemnify and hold the <br /> Township harmless according to the conditions stated on the reverse side, during any and <br /> all work activities by those other than Township personnel. <br /> The Town of Christiana granted this permit at a meeting held on: <br /> wv �` 20 1 (,0 <br /> • <br /> Town Bo. d em I-r Town Clerk <br /> ftw <br />