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TOWN OF RUTLAND DRIVEWAY PERMIT <br /> (For Access From Private Property To Town Road) <br /> Name & Address of Applicant <br /> lf - ( I4 - <br /> .7S-9Y S firttcse 6/(41.1y Dig <br /> Ulf2 fea wki 1AJL 5 '3 Sq,> <br /> Phone <br /> Location: Side of $tia/12(ce Rd <br /> R J. <br /> Located /c( Mt /Feet From Qost k f r'cI t <br /> in Section , Town of Rutland <br /> CONDITIONS <br /> Width of driveway: Feet. <br /> Center of driveway from property line: g(,) Feet; <br /> ( k) No drainage culvert needed. <br /> ( ) Drainage culvert needed. Size: Length Feet . <br /> Diameter Inches <br /> --ether Requ--rreme-n-mss-; . <br /> Permit granted: -7/1,,g (,,, ) Date £ .i"2 1. <br /> Town of Rutland <br /> (1 copy - Town*) (1 copy - Applicant) (1 copy - Dane County <br /> Zoning) �,' <br /> W <br />