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• <br /> DANE COUNTY ZONING DIVISION • - •1:•••• <br /> r •*. • <br /> • <br /> CITY COUNTY SUILDINS.vot 126 • . <br /> ri <br /> MARTIN LUTHER IONS,JR.MVO. • <br /> MADISON,WISCONSIN 53703-3342 ••''•,*fr -4/ <br /> • <br /> PHONE 266-4266 PAX 267-1540 . <br /> ww.courdvofdane.comkoning <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION.AS POSSIBLE, <br /> 1. LANDOWNER: VgILIDIB4 ILLAGS ASENT: <br /> ADDRESS: 121150131MilkTMM)B1* Diad ADDRESS: <br /> k4aBOIS6o4 141 salts <br /> PHONE: tont . 2.21 .. CVL1 PHONE: <br /> EMAIL: MAIL: <br /> Z. TYPE OF PROJECT: • <br /> ESTIMATED COST OF CONSTRUCTION: $ —Z11 111-7 • <br /> f5trxicture plus machanicals.) <br /> 3. ADDRESS OF PROTECT,IF KNOWN: Cn1 P•e, <br /> 4. LOCATION OF PROJECT: <br /> TOWNSHIP,SECTION 1/41/4 1.1 OF kd <br /> TAX PARCEL NUMBER • <br /> StiODIVZSIGN CSA1#(Certifxd*Amy Mop),IF ANY: <br /> LOT NIJAWElt IF ANY: s 5 / <br /> 6. ZONING DISTRICT: *1 t OnSing_.—..■ <br /> 7. SITE PLAN: *A site plan must be&awn to scale showing the lot lines and bt&mansions,the!mew <br /> and size of all**stag and proposed bullshit's m additions and their distances from <br /> bt lines If the lot is not served by pislic sewer,the location and size of the on-site <br /> septic system and the location of the mall shall be show on the pbn. <br /> Exaterk of e She Pke Ws revese. <br /> S FLOOR PLANS AND ELEVATION VIEWS(front. Was. rear): A copy wi I be kept in Drains Division Nal <br /> rowesples of Moor Mans end Ilievetioste attached. <br /> 9. SEWER OR PRIVATE SEPTIC Sr Al? <br /> 'STATE SANITARY PERMIT NEEDED? N IF YES. PERMIT X <br /> APPROVAL FOR ADDING BEDROOM OR ) 25%AREA NEEDED? V PO IF YES. PROVIDED? <br /> 10. DRIVEWAY(N•Culvert or Amass)PERMIT NEEDED? YQIF YES. PROVIDED? a <br /> Many mans require a brnsway Permit*County Highway Deportment or HOOT permits may be required for <br /> drivenays with access to a County,State or US irschmay <br /> 11. SHORELAND? Y FLOODPLAINT WETLANDS Y <br /> 12. TOTAL AREA OF DISTURBANCE(Square felt) <br />