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• <br /> FEE: $250 <br /> TOWN OF SPRINCIU.\1.1: <br /> I lall Rd.Nit.i lorb.\\ I <br /> z0I info(alsprinedalewi.gov <br /> DRIVEWAY PERMIT APPLICATION <br /> Please return this application and the following to the address or email above: <br /> • Sketch of driveway location on Town-approved site plan; <br /> • $250 application fee;and <br /> • Copies of deed restrictions,shared driveway agreement and/or other property agreements that may <br /> impact the driveway location. <br /> Once this application is received by the admin/clerk,the Town Board chair will arrange a site visit.Please ensure the <br /> proposed driveway is staked before the visit. <br /> ;;t,! i! + r'1' INFOR\'I I i()\ (Completed byapplicant;please print) <br /> \�hn P�FArr. ifZ Date 6112.4` Z2 <br /> Applicant Namc(s) � :t.1'Y�fl.1f't'�'LG-- J <br /> Applicant Address: gS20 Ch-e, -re, ( Ve '' Wl 53S`+3 <br /> Email � <br /> IS'IO e 00±A ,k- • G r ee <br /> Phone Ztu2- `l`-E � lGl1 <br /> LCD 3 TUV.%r HG-•11 �[n,�- n Shared?Y/N <br /> Driveway Address t cp. n ei ere e-2 <br /> Sec.Y�Tty t-4 Parcel Number: CY, /(3to 0-1 —CZ3- O <br /> r/$ JW side of I�c>�" J TOLL;)--1 <br /> F' eLA Rczt41 EZ-IS <br /> CON DI'1'IONS (Completed by Town) <br /> Dane County and DNR regulations may apply;contact local offices All driveways and culverts must comply with <br /> Springdale's Private Driveway Ordinance and Driveway Construction Guide.Driveway permits parts I &2 <br /> must be secured prior to receiving a Town building permit or Dane County zoning permit.Approval is subject to <br /> conformance with building envelope on file at town hall.Duplicate rural numbers arc required for shared driveways. <br /> Blue oval markers are required on address posts for driveways longer than 1,000 feet. <br /> Engineered plans required Y/N <br /> Shared driveway agreement required Y/N <br /> Culvert Y/N <br /> Agricultural use only Y/N <br /> Width single: 12'driving surface, 14'roadbed <br /> shared: 16'driving surface,18'road bed <br /> Grade I0%maximum <br /> AP t'Kt) Ai. (Completed by Town) <br /> Permit is valid for 1 year from dale of approval.Permit pending CSM recordation at Dane Co.Register of Deeds. <br /> Fcc Itee'd Date (1D'y l _ Check# gbl irons: `_nirjer '-- <br /> Q- / -� k .� U 7Z-7 own Chair <br /> Part 1*Issued Date): <br /> For proposed driveways off Town roads.Part t is grouted by r r wn Board.For driveways oil county or state roads.Part I is granted by that <br /> governing body and shall be obtained bv the applicant and aro dtothe Town beloredr'•ewayconst t,'tion mug begin. <br /> Part 2**Issued(Date): <br /> a — Z �. t Town Chair• <br /> "Issued by the Town Board,%rant the access point(Part I)tot • tiding site. <br /> P,\t.,:ti <br />