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• <br /> DANE COUNTY ZONING DIVISION . <br /> IVISION �! ,' . <br /> CITY COUNTY WILDING, RA 116 ` ` <br /> 210 MARTIN LUTHER KING.31.BLVD. t� s, ;�; ; <br /> MADLSON,WISCONSIN 53703-3142 <br /> PHONE 266-4266 FAX 267-1540 <br /> www.countVOfdane.com!ZOniRQ <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> 1. LANDOWNER: V get D T Owl iAlst.A6S : <br /> ADDRESS: 2 9i ak- -TD flJ I W ADDRESS: <br /> Ms%0tSea.1• hi I 5x'113 <br /> PHONE: 6A$ 4 224.• 31 tsi PHONE: <br /> EMAIL: MAIL'• <br /> 2. TYPE OF PROJECT: • ,- a •• w* (Structure planJnanico/s.) <br /> ESTIMATED COST OF CONSTRUCTION: ,f <br /> 3. ADDRESS OF PROJECT. IF KNOWN: _._.____LAL____J_---"A-a (-04-e <br /> 4. LOCATION OF PROJECT: <br /> TOWNSIP,SEC7ION,1/4L4 1W0 OF n‘&60;b7-0 <br /> TAX PARCEL.NUMBER <br /> SUBDIVISION OR CSM#(Certified Survey Mop),IF ANY <br /> LOT NUMBER IF ANY: I <br /> 6. ZONING DISTRICT: -`\C\4 L'A'Aill—rd) <br /> I <br /> 7. SITE PLAN: 'A site plan must be drawn to scab shooing the lot lines and lot dimensions, the IcatiOO <br /> I and size of all existing and proposed buildings or additions and their distances from <br /> — lot lines. If the lot is not serrsdby public sewru', the location and size of the on-site <br /> septic system and the bastion of the sell shall be shown on the plan. . <br />+I Example of a Ste Alai ae'wave. <br /> 8 FLOOR PLANS AND ELEVATION VIEWS(frail. sides, rear): A copy will be kept in Zoning Division P&L <br /> Examples of Aran Puns aW Bervtions attached <br /> 9. PUBLIC SEWS:OR PRIVATE SEPTIC SYSTEM? D 5 Al I I Z �` <br /> STATE SANITARY PERMIT NEEDED? (N IF YES, PERMIT* .-�' <br /> APPROVAL FOR ADDING BEDROOM OR s 25%AREA NEEDED? Y e IF YES, PROVIDED? Y <br /> 10. DRIVEWAY(sr Culvert or Aoosss)PERMIT NEEDED? V l ^I IF YES, PROVIDED? Y 0 . <br /> Many Townsnrsquirre a OrrirsrrayAr nit,County ► !'Department or WDOTpmts may ^ �r . <br /> &hare ays NOM access to a County,State o VS Mighaay <br /> WETLANDS Y/ � <br /> 11. SHORELAND? Y I N-- FLOODPLAIN? y/i d; <br /> 12. TOTAL AREA OF DISTURBANCE(Square feet) V <br />