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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> 7 <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME TIM OBRIEN HOMES I <br /> Cf(Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 4868 HIGH CROSSING BLVD,MADISON,WI 53704 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)661-1100 sfrohling @tobhomes.com IN Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME . <br /> Sue Frohling TIM OBRIEN HOMES ❑Site Plan jnluding location <br /> wej <br /> AGENT ADDRESS CONTRACTOR ADDRESS of eptic <br /> 4868 HIGH CROSSING BLVD 4868 HIGH CROSSING BLVD <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> MADISON,WI 53704 MADISON,WI 53704 <br /> PHONE PHONE ❑Site Plan proval from <br /> (608) 661-1100 (608) 661-1100 applic a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MREARDON @TOBHOMES.COM A Koor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p p y <br /> ❑PARCEL 068/0910/294-4007-0 R-2 0.54 frontage drawn to scale. <br /> NUMBER �.1� ' 1 <br /> TOWNSHIP: SECTION: � �'V <br /> TOWN OF WINDSOR(09) 29 1/a: '— '/a'/a: ^sue ❑Drivewa ermits <br /> (state ounty,town) <br /> ADDRESS r p IN> Dusky Glen <br /> 04.... 0 Sanitary permits <br /> CSM: LOT 272 SUBDIVISION BLOCK/LOT (public,private) <br /> PROPOSED PROJECT INFORMATION WP77` <br /> PROJECT DESCRIPTION: i - - ` - ass�. <br /> SINGLE FAMILY HOME +N C , ' r `rt <br /> . 0 This project is a new building or structure. t 4elfen 2 <br /> ❑This project is an addition/alteration to an existing building or structure. r <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> t fix- <br /> EWER FIEPTIC �� ., $t r „,4A''.'.k} , <br /> HEIGHT IN FEET: 3 NUMBER OF STORIES: (Not including basement) :•- "t ' x :` K <br /> LI � � <br /> AREA TO NEAREST SQUARE FOOT: -. ° , <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) . k l* lx <br /> BASEMENT: 1ST FLOOR yn <br /> 1 ,800.0 SIP / -I'.74J.0 + TOTAL SQUARE FOOTAGE: + 4 V ( r <br /> 2ND FLOOR: 3RD FLOOR: ll 4i I I � <br /> -1-1`[ t <br /> ESTIMATED CONSTRUCTION COST: = I C <br /> (Please round to nearest dollar) ♦ ♦ ♦ .- ♦ ♦ $ 237 738.00 V Y k V hp _? <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ONo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yeslo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? QYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes 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 ENo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes �No <br /> , <br /> -li”. APPLICATION MUST BE SIGNED <br /> ': �. (Continue on Back) ♦ -+ <br /> 545-112(4/08) ���•=J► <br />