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06/04/2008 WED 13:36 FAX 608+223+9465 Advantage Freight Sys. 1002/002 <br /> • <br /> 3. In the event a culvert is required,said culvert shall be covered by sufficient material <br /> to protect it from the weight of vehicles using the access. <br /> 4. Placement and maintenance of culvert is the responsibility of the property owner. <br /> 5. All dimensions and construction of accesses will adhere to Dane County and Town of <br /> Pleasant Springs standards. <br /> 6. Nothing may be placed in the public right-of way except legally constructed <br /> mailboxes <br /> 7. The Property owner is responsible for damage to road edge caused by demolition <br /> and/or construction. <br /> AI{NOWLEDGEMENT: <br /> As owner of the above named property,I acknowledge and agree that I am responsible for <br /> any damage to the roadway, shoulder or right-of-way,which occurs during the emolition <br /> and/or construction process,up to and including any time period until an occupancy <br /> permit and/or final demolition inspection notice from the Town of Pleasant Springs <br /> Building Inector is issued and received by the Town.I agree that the damage deposit of <br /> $ 00a I make will be retained until the Town Board acts to release the deposit. <br /> No deposit will be returned until all inspections are complete and compliant. Costs for <br /> any damage,solely determined by the Town,will be deducted from the deposit prior to <br /> return. <br /> 6 A,or <br /> Property Owner Sign Date <br /> Approval of initial access <br /> 4 2 <br /> To• Repres a' •tiv-• Dat <br /> Additional Access: <br /> Access nted/denied_by_the_Iew t-BQa?si_o_n- 20_ <br /> Reason for denial <br /> • Deposit amount: VifJb- ° Type: )( personal check <br /> money order/cashier's check <br /> Date deposit authorized to be returned by: Public Works Staff: <br /> Town Board: <br /> Date deposit authorized to be held by Town Board: <br /> Date deposit returned by Clerk/Treasurer. <br /> Comments: <br /> C:\Shared\Word files\ROADS\Documcnts\access permit rcvised June 2007.doc <br />