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TOWN OF SPRINGDALE DRIVEWAY PERMIT APPLICATION DATE: -2A 4 <br /> I. CONTACT INFORMATION - To be Completed by Applicant: <br /> Name and current address 5-7- U(c- 4-- jj/// ire& l/) <br /> of applicant <br /> e rh/cif ,L.s, ml M wrs3S 72-a-• <br /> ca (./-3(./-3?- 316 <br /> Current telephone number: wsrk 742 -a home <br /> Driveway location in Springda ` //Q/1{// J/ <br /> J <br /> Location: west east i-sout 11101i, side of Sec. <br /> Parcel number:- - k) - ()CO_ - ' Z ! --,b S GU--/ . <br /> Contact Ed Eloranta, Town Chairman, #437-4692, to arrange a site visit. <br /> Please attach a drawing of the driveway location discussed at the site <br /> visit and return to the Town of Springdale, 2379 Town Hall Rd. , Mt. <br /> Horeb, WI 53572 as soon as possible after the site visit. <br /> *********************************************************************** <br /> II. CONDITIONS - To be completed by Town Board member or its agent: <br /> l.2 'SuJ v <br /> Width of driveway: /cf// � f'e�et Maximum grade of 10%. <br /> - Drainage culvert needed: no yes <br /> If culvert required, must meet Driveway Construction Guide standards. <br /> Agricultural use only: no yes <br /> Shared driveway agreement required: x no yes <br /> Other requirements: <br /> 1. Shall comply with town private road ordinance and driveway <br /> construction guide for new driveways. <br /> 2. Shall contact Town Patrolman Dan Chancellor at 437-3648 before <br /> starting construction of the driveway. <br /> 3. No Building Permit shall be issued until Driveway Permit Part 1 AND <br /> Part 2 has been issued. <br /> 4. <br /> *************************************************************** **-***** <br /> III. APPROVAL - Date Approved By Town Board: *ti& Date Issued:3/, 0,./, <br /> 7/./.4.,(_ / I, , ,� - -/�. <br /> The Driveway Permit is valid for one year from date of approval. <br /> The Driveway Permit is pending recordation of the Certified Survey Map <br /> at Dane County Register of Deeds <br /> Permit Part 1 Driveway Permit Part 2 Single Residence Duplex <br /> $100.00 FeePl. Reminder:Dane County Erosion Control Standards may <br /> apply. <br />