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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Norman & Melba Rick <br /> OWNER ADDRESS (Number,Street,City,State,Zip) IQ Zoning Status;CUP; <br /> 2418 Town Hall Rd, Mount Horeb WI 53572 Deed Restriction; CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (608)437-5258 <br /> AiAGENT INFORMATION 1 CONTRACTOR INFORMATION Site Plan drawn to scale <br /> AGENT NAME and includes dimension <br /> CONTRACTOR NAME <br /> Dennis Dignan Badger Home Improvement !J" <br /> AGENT ADDRESS Site cluding locati <br /> 144 Glen view Rd CONTRACTOR ADDRESS of <br /> 144 Glen view Rd <br /> (City,State,Zip) (City,State,Zip) 1/ Setbacks 6 . 401.25//0 <br /> Mount Horeb, WI 53572 Mount Horeb, WI 53572 <br /> PHONE PHONE Site Plan approval <br /> (608) 437-5698 (608) 437-5698 applicable township. A/, <br /> E-MAIL ADDRESS E-MAIL ADDRESS /v <br /> dennis@badgerhomeimprovement.com dennis@badgerhomeimprovement.com 141 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> ID PARCEL <br /> T PARCEL NUMBER: CURRENT ZONING: ACREAGE: I Elevation of property / <br /> NUMBER 0607-212-8500-7 Al 1 g rontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Springdale 21 '/a. NW %IA: NW td Driveway perm' <br /> ADDRESS: 2418 town Hall Rd (state,coun town) <br /> CSM: LOT SUBDIVISION BLOCK/LOT ` Sanitary <br /> 1''f (public vate <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: / ? `ST {�;W <br /> 14'X18'Addition., � 4(y‘ ---- �- La ,,,Pr r (ro o w L./ c v^4_ �✓ ) Zoning Disttjct '--� <br /> OThis project is a new building or structure. 310 q. <br /> This project is an addition/alteration to an existing building or structure. $ Use? i P �� <br /> SANITARY SERVICE: PERMIT NUMBER: j Rural ' a >;,• �� <br /> EWER P1EPTIC ( . ��3> <br /> HEIGHT IN FEET: lD/ NUMBER OF STORIES: (Not including basement) <br /> 1.0 ,�-,, . /Ffoodplain! 4' 1,00 <br /> AREA TO NEAREST SQUARE FOOT: *.,(attaChCngnt) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 0.0 1ST FLOOR:252.0 pmt <br /> 252,O j TOTAL SQUARE FOOTAGE: l rbartoe <br /> 2ND FLOOR:0.0 3RD FLOOR: 7/` <br /> 0.0 252.0 { ' <br /> ESTIMATED CONSTRUCTION COST: BY) survey <br /> (Please round to nearest dollar) "+ ♦ -► "'► -i -► $ 50,000.00 and a1tBE tlpt1t71CtS, � <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ✓N° ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Q✓Yes [(Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? OYes Eto <br /> o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? OYeS I_j"Jo <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) .... Dyes ✓N° ODon't know <br /> 7. Is this to correct a violation? ' _ O o <br /> t ( Yô, <br /> APPUC' ION MUST BE SIGNED <br /> 545-112(4/08) (Conti .e on Back) -4. -► -+ <br />