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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Four Empty Milk Cans LLC <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number.Street,City,State,Zip) Deed Restriction; CSM <br /> 702 N High Point Rd Madison WI 53717 Variance(# ) <br /> HOME PHONE 'CELL PHONE E-MAIL ADDRESS <br /> (608)235-9220 (608)235-9220 ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Tony Hienrichs Trademark Homes LLC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1113 Kohiba Court 702 N High Point Rd <br /> (City.State,Zip) (City.State.Zip) ❑Setbacks <br /> Verona WI 53593 Madison WI 53717 <br /> PHONE PHONE <br /> El Site Plan approval from <br /> (608) 235-9220 (608) 577-1860 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dbrickley @starkhomes.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (httpJ/accessdane.co.dane.wi.us/) <br /> El Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑NUMBER 0608-351-9500-5 <br /> 4 _� t. frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Verona 35 1/4: '�4+�4: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 6622 Sunset Drive <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION tr, a"=. <br /> PROJECT DESCRIPTION: -� P r <br /> building a new structure on a existing foundation c d r?e9cc) _ ,;, ,a }:, , <br /> S <br /> . ❑This project is a new building or structure. -- (°(lss <br /> 12 This project is an addition/alteration to an existing building or structure. 1 . a <br /> SANITARY SERVICE: PERMIT NUMBER: - ° � <br /> rEWER PEPTIC 13,201 ,500,006 > F �� �1 z <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) r* gam° " a <br /> 15.0 , , � <br /> AREA TO NEAREST SQUARE FOOT: ak. <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) 4 _, <br /> BASEMENT 1ST FLOOR: <br /> 1 ,251 .0 1 ,251.0 j TOTAL SQUARE FOOTAGE + ` , <br /> 2ND FLOOR: 3RD FLOOR: 6l <br /> 2,502.0 f4 , <br /> ESTIMATED CONSTRUCTION COST: ' 7_� <br /> (Please round to nearest dollar) 1 50 000.00 °� �, . <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes ✓ 'Jo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Efres Elo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes I'lo <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 ❑No ❑Don't know <br /> 7. Is this to correct a violation? -7 r -7 ❑Yes ✓alo <br /> 57% `f)I v v©o APPLICATION MUST BE SIGNED <br /> (Continue on Back) --■ -♦ <br /> 545-112(4'08) <br />