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, ; <br /> Certification <br /> As owner/applicant of the above described property, I/we certify that that the information provided herewith is true to <br /> the best of my/our knowledge,and I/we agree to abide by the provisions of the Town of Vermont Land Use Plan and <br /> ordinances. <br /> I hereby give permission to the Town Board and/or their representative to enter the property in order to evaluate the <br /> site and to verify compliance with and/or to enforce the Land Use Plan and ordinances. <br /> Owner Name(print): Charles and Kate Langfeldt Owner signature: Date: 7/18/16 <br /> Applicant Name(print): Charles and Kate Langfeldt Applicant Signature: Date: <br /> Received on this Iq day of ,20j Qi by 4'41X-eiel C t(t (town officer) <br /> Actions—For Town Use Only � <br /> Plan Commission Action:'. Approved_Not Approved Date:--11` /c c ft UQ <br /> Fees Paid:$ Date: <br /> *For driveway application:An engineering plan_is_is not required. <br /> Comments: <br /> Board of Supervisors Action: Approved Not Approved Date: 'II(CP <br /> Driveway permit expires: $' C; 30(9 <br /> Comments: <br /> County Board Action:_Approved_Not Approved Date: <br /> Comments: <br /> inspection of Driveway&Permit Reinstatement <br /> _Driveway was constructed in accordance with the plan approved the Town Board <br /> _Driveway is not acceptable <br /> _Applicant will make required improvements by (date) . <br /> Comments: <br /> The Vermont Town Board_approved_disapproved reinstatement of this driveway permit. <br /> Signatures of Town Board Driveway Committee: <br /> Signature: Date: <br /> Signature: Date: <br />