Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jeff Demets <br /> p Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State.Zip) Deed Restriction; CSM <br /> 3072 Niesen St.,Cross Plains,WI 53528 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)798-1934 mitm19 @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dave Budden Meigs Inc.-Dave Budden ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1527 Hwy 14,P.O.Box 412 1527 Hwy 14, P.O.Box 412 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Black Earth,WI 53515 Black Earth,WI 53515 <br /> PHONE PHONE <br /> ❑Site Plan approval from <br /> (608) 767-2729 (608) 767-2729 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com dave @meigsbuilds.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑PARCEL 0706-251-9820-1 A-1(Ex) frontage drawn to scale. <br /> NUMBER ( ) J. <br /> TOWNSHIP: SECTION: <br /> Vermont 25 � : NE �/4�/4. SE ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 9511 West Mineral Pt. Rd, Mt. Horeb, WI 53572 <br /> CSM: LOT SUBDIVISION BLOCK/LOT (�publi ry • <br /> (public, •rivate) <br /> PROPOSED PROJECT INFORMATION STAF I .IEW <br /> PROJECT DESCRIPTION: � <br /> Storage Building \( ciAA A11. p liloning District <br /> 4This project is a new building or structure. lldPermitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: y PERMIT NUMBER: CI Rural ' • <br /> FIEWER I (new/CO <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 19.5 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionControl permit <br /> 4,320.0 + TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> NKtfilling/access) <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -, ♦ ♦ — ♦ ♦ and available options. <br /> (Please round to nearest dollar) $ 80,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes No ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓Zlo <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) Ekes Jlo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) <br />