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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Lee King <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Oning Status; CUP; <br /> 9852 County Y Mazomanie, WI 53560 Deed Restriction; CSM <br /> HOME PHONE i CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (608)963-8050 (608)963-8050 �r s <br /> AGENT INFORMATION i CONTRACTOR INFORMATION Eijo� Plan drawn to scale <br /> AGENT NAME and includes dimensions <br /> Dave Budden-Meigs Inc. Meigs Inc. NAME <br /> g Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS <br /> P.O. Box 412, 1527 Hwy 14 P.O. Box 412, 1527 Hwy 14 of well/septic <br /> (City,State,Zip) (City,State,Zip) et kS <br /> Black Earth, WI 53515 Black Earth, WI 53515 <br /> PHONE PHONE Site Plan approval <br /> (608) 767-2729 (608) 767-2729 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com dave @meigsbuilds.com Floor lans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: levation of property <br /> 0 PARCEL 034/0906-231-9280-5 <br /> NUMBER RH-1 3.87 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Mazomanie 23 1/4: NE 1/1/4: SW Drivewa -:: <br /> ADDRESS: (state, ount <br /> 9852 Hwy Y �►�G <br /> CSM: 3,893 LOT SUBDIVISION BLOCK/LOT anitary!,,,,Itits <br /> 3,893 (public,f• <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: \ <br /> Shop <br /> • This project is a new building or structure. <br /> .;:t1 '..".s. .,411"44.'4.-..,:llt- l'..'-„k3':.:'-'0,' ,i <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: <br /> PERMIT NUMBER: a ,:°s <br /> EWER �EPTIC R . a *t.€. ° <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 24.0 1.0 <br /> AREA TO NEAREST SQUARE FOOT: �= x `` .- ' <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ,,,, <br /> BASEMENT 1ST FLOOR: Y , � � +��i 9r��,-.,1 � <br /> 2,052.0 4 TOTAL SQUARE FOOTAGE: o w :t4 , .; ; <br /> 2ND FLOOR: <br /> 3RD FLOOR: �: � .r<� ,� :- <br /> 2,052.0 <br /> ESTIMATED CONSTRUCTION COST: ' ° ' <br /> (Please round to nearest dollar) '+ -► -► $ c3z ) , - <br /> F <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ✓ Jo [Don't know <br /> 2. Is there a wetland or floodplain on or near the property? <br /> [Yes Erlo [Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ✓[Yes EINo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes I_P io <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# <br /> ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) <br /> [Yes ao [Don't know <br /> 7. Is this to correct a violation? <br /> [Yes ✓QNo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) ■ -► -♦ <br />