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V <br /> TOWN OF SPRINGDALE DRIVEWAY PERMIT APPLICATION DATE: (9- '1 r7 GA02y <br /> I.CONTACT INFORMATION-To be completed by Applicant: Z� x,3 <br /> Name of Applicant C /0 v C /-)0.14-1,./1 - // OFf Z/9.- 9/Qu► lTy c"-41.77 <br /> Current Address S 1, /4gASI , PAe . V1 L t E, L.F, S.?7� <br /> Current Telephone Number:Work 4 0 f 6- 7 Y 5-- e&7 Z Home/Cell (p o - fry l 7 -/ to 13 7 <br /> Driveway Location in Springdale: T 3 <br /> Location: West y East South % North side of 6&742. /to Sec. <br /> Parcel Number: C fr t 4(1 2 <br /> 1.Contact Mike Fagan,Town Chairman at 608-437-6230,to arrange a site visit. <br /> 2.Please bring to the site visit copies of any and all deed restrictions,sketch of town-approved <br /> building envelopes,property agreements,etc.which could impact the location of the driveway and <br /> buildings. <br /> 3.Please attach a drawing of the driveway location discussed at the site visit and return to the Town <br /> of Springdale,2379 Town Hall Rd.,Mt.Horeb,WI 53572 as soon as possible after the site visit. <br /> H.CONDITIONS-To be completed by Town Board member or its agent: <br /> Width of single-use driveway: 12'driving surface, 14' road bed <br /> Width of shared driveway: 16' driving surface,18' road bed <br /> Maximum grade of 10%. Shared driv -a reemcnt required: No Yes <br /> / <br /> ° Drainage culvert needed: No Yes Agricultural use only: No Yes <br /> /If a culvert is required,it must meet Driveway Construction Guide standards. <br /> /Other requirements: <br /> L/ 1.Shall comply with town private road ordinance and driveway construction guide for new <br /> driveways. <br /> --- 2.Shall contact Town Patrolman Devin Dahik,at 437-3648,before starting construction of the <br /> )'driveway. <br /> 3. No Town Building Permit or Dane County Zoning Permit shall be issued until Driveway Permit <br /> Part 1 AND Part 2 have been issued. <br /> 4.This approval is subject to conformance with the Town-approved building envelope(s)on file in <br /> the Town of Springdale Town Hall. <br /> 5. Duplicate rural numbers are required for a shared driveway. <br /> 6.A blue oval marker on the address post is required for driveways longer than 1000 feet. <br /> c III.APPROVAL-Date Approved by Town Board: Date Issued: /i /i <br /> . ra <br /> . The Driveway Permit is valid for one year from date of approval.The Driveway Permit is pending <br /> 5( recordation of the Certified Survey Map at Dane County Register of Deeds. <br /> ermit�' 1,Driveway Permit Part 2,Single Residence,Duplex,Agricultural <br /> 4, 100.00 Fee ))Reminder: Dane County Erosion Control Standards may apply. <br />