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TOWN OF COTTAGE GROVE <br /> DRIVEWAY PERMIT <br /> (For access from private property to a town road) <br /> Name and address <br /> of applicant <br /> (Y) Ff "lc <br /> -67) r41.-. 4J, <br /> (11A6 / SaA ) 4/' 557( 3 <br /> Phone 3 - <br /> Location: ) ' 4 7 -&i4e r e.r. <br /> located miles/feet from <br /> in Section , Town of 0_411114,e, (67(11)4) <br /> CONDITIONS <br /> Width of driveway: feet. <br /> Center of driveway from property line: feet. <br /> [ ] No drainage culvert needed. <br /> i4Drainage culvert needed Size: Length f / feet <br /> Diameter / inches. <br /> Other requirements: <br /> f.1'ti1�J tt!4 e t ilr <br /> Permit granted: A - Y- <br /> t;4r; <br /> Town of: ( " t(i)/' (Tire <br /> [White copy-Town; Yellow copy-applicant; Pink copy-Dane County Zoning] <br />