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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App#
<br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE
<br /> OWNER NAME
<br /> Basil Tikoff and Sara Hotchkiss Zoning Status;CUP;
<br /> OWNER ADDRESS (Number,Street,City,State,Zip) (heed Restricfion CSM
<br /> 2517 Balden St.Madison,WI 53713 Variance(#<j 1 4:3
<br /> HOME PHONE CELL PHONE E-MAIL ADDRESS
<br /> (808)895-1038 basil @geology.wisc.edu;shotchkiss @wisc.edu 19 Site Plan drawn to scale
<br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensio
<br /> AGENT NAME CONTRACTOR NAME
<br /> Matthew Tills Robb Thole,The Thole House, LLC 12 Site Plan including location '
<br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic h.2501 Balden St. 1608 Blue Ridge Trail
<br /> (City,State,Zip) (City,State,Zip) NI Setbacks
<br /> Madison,WI 53713 Waunakee,WI 53597 NI Site Plan approval from
<br /> PHONE (608) 235-6240 PHONE (608) 513-3983 applicable township.
<br /> E-MAIL ADDRESS E-MAIL ADDRESS I i
<br /> matt@tillsarchitecture.com thetholehouse @charter.net Fl Floor plans to scale
<br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usl) Q Elevation of property
<br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: frontage drawn to scale. ,
<br /> P2 PA NU 032-0709-273-6656-5 R-2 MBER RCEL 0.50
<br /> TOWNSHIP: SECTION: C Fl Driveway permi
<br /> Madison Z '/a: ,�111 '�a'�a: (state,county own)
<br /> ADDRESS-
<br /> 2517 Balden Street
<br /> Fl Sanita
<br /> CSM: LOT SUBDIVISION BLOCK/LOT
<br /> (pub!. ,private)
<br /> 6 Forest Park 3
<br /> PROPOSED PROJECT INFORMATION '. a t ' ,p
<br /> PROJECT DESCRIPTION: s fi aft'
<br /> Demolition of existing garage and screened porch,new addition of garage,two bedrooms,and screened porch .4a * District .< • C7
<br /> oy r
<br /> This project is a new building or structure. ►f , .4 K f
<br /> Fl This project is an addition/alteration to an existing building or structure. � 9
<br /> SANITARY SERVICE PERMIT NUMBER: `
<br /> EWER EPTIC :I
<br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement)
<br /> ' ".
<br /> 1
<br /> 26.3 1.0 t i4 r 4..4A o�, :
<br /> AREA TO NEAREST SQUARE FOOT: "N e '
<br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) )%+,a ,,,,/,,,,,,,,,.,:,,.,„,,,; ,
<br /> BASEMENT: 1ST FLOOR
<br /> 1 060.0 4. TOTAL SQUARE FOOTAGE: 4, �gL;� #�s�digs . .
<br /> 672.0 filling/a
<br /> 2ND FLOOR: 3RD FLOOR:
<br /> 1 ,132.0
<br /> *le'
<br /> ESTIMATED CONSTRUCTION COST: !"* ,° /7-
<br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ $ 21 0,000.00 ,:" S,, , .,,.;;,",ui.
<br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? la es No ❑Don't know
<br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes JNo ❑Don't know
<br /> 3. Have you talked with the township about your project and are they in agreement? Des ❑No
<br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Des ONo
<br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none)
<br /> 6. Is a location survey required? (see reverse) ❑Yes ONo ❑Don't know
<br /> 7. Is this to correct a violation? [Yes ONo
<br /> �,----- APP L ICA• ST BE SIGNED
<br /> (Continue on Back _
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