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, <br /> 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 /> rI <br /> Phone j <br /> Location: side of <br /> located miles/feet from `- r4 i . (ICI <br /> in Section "" ""1 , Town of -'4�` ` ' { <br /> CONDITIONS <br /> Width of driveway: feet. <br /> Center of driveway from property line: feet. <br /> [ ] No drainage culvert needed. <br /> [ ) Drainage culvert needed Size: Length feet <br /> Diameter inches. <br /> Other requirements: <br /> // 1/ .. .,_.._�._._. Date !.f _ �. <br /> Permit granted: /C <br /> Town of: <br /> [White copy-Town; Yellow copy-applicant; Pink copy-Dane County Zoning] <br /> l i <br />