CULVERT/DRIVEWAY PERMIT
APPLICATION Approved ( ) Disapproved ( )
If disapproved, state reasons:
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DATED: _______________________, 20____ SIGNED: ______________________
CERTIFICATION
The undersigned has inspected the construction and installation set forth above and finds that the same (is) (is not) in accordance with the permit.
DATED: _______________________, 20____ SIGNED: ______________________
(2009 Code, Ch. 34)