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U <br /> w I. _ <br /> li <br /> TOWN OF DEERFIELD <br /> DRIVEWAY EMIT <br /> (For access from private property to a town road) <br /> Name and address '"-'^ <br /> of applicant 7,d J, to olh tf r _i <br /> Li( S — -57i42o.72-W rli '). • <br /> i)cer it,e ki biT a--- SS 3 / <br /> Phone g _ 795 <br /> Location: !- .I aide of '-' 1 r-',; i K c( <br /> located miles/feet from > _ _ <br /> in Section , Town of ` , <br /> // CONDITIONS <br /> Width of driveway: 26. feet. <br /> Center of driveway from property line: feet. <br /> [ ] No drainage culvert needed. <br /> C ] Drainage culvert needed Size: Length 2 6 1 feet a <br /> Diameter /C inches. <br /> Other requirements: <br /> Permit granted: Date <br /> Town of: <br /> [White copy-Town; Yellow copy-applicant; Pink copy-Dane County Zoning] <br />