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/ .., <br /> ZONING PERMIT APPLICATION wwwcountyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME t <br /> YYI(s ) L L C - - <br /> ( e�-t. ��c. l min �i • <br /> V-OWNER • '8. (Nu tier, ,Sma. - ,) mg Status;CUP; <br /> �� Deed Restriction;CSM <br /> _ l�.IV 1 1 I s. , _.I C( Variance(# ) <br /> H„M a CELL PHONE - E•MAILADDRESS <br /> #611 's, �.fi drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and i es dimensions Kc Ael j/ CONTRACTOR NAME <br /> AGENTJ� V Plan Including location <br /> AGENT ADDRESS/ .• -, .4, .- S � 1 <br /> ( .sm�w) Masts.z�) G�'�etbacks <br /> PHONE PHONE ❑ Site - -. . "TT'al from <br /> '• '.'le n ship: <br /> E MMILADDRES,S E.MA LADDRESS <br /> R •• plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:!;accessdane.co.dane.wi.usr) y211 -011 <br /> L PARCELNUMBER CURRENTZONING: ACREAGE: of perty <br /> N NUMBER 0'/0 13. 0 -. / g d - to scale. <br /> \/TOWNSHIP: t SECTION: II ;4 P ItS <br /> ADDRESS: (— '-, `. town) <br /> St t-- ••• L <br /> la <br /> iii <br /> CSM: LOT- SUBDIVISION ' BLOCKA.OT <br /> PROPOSED PROJECT INFORMATION ,�( <br /> PR7,- Frn°7(c- .-r e_— QLO_Ki <br /> • • - is project is a new building or structure. <br /> 0 This project is n addition/alteration to an existing building or structure. <br /> SANITARY -z:- ;._NUMBER' --_-- <br /> 0 SEPTIC 0/ ., , <br /> k /IHEIGFrrMFEET -b n. .t NUMBER OF •• : (Not Indudl g basement) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions induding unfinished area,attached garages and above grade decks or porches) <br /> B�'h aI��97� 1STFLOOR <br /> � j TOTAL SQUARE FOOTAGE: ,, <br /> 2ND FL O 3RD FLOOR <br /> X383 S9' <br /> i <br /> ' <br /> ESTIMATED o a 1 ■ <br /> (Please round to t i -0. -0. -0. -r -10 -0. ' 4-9 I 3 3/0, <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes lib. .0 Don't know �/ <br /> 2. Is there a wetland or floodplain on or near the property? o Y m 0 Don't know / <br /> 3. Have y u talked with the township about your project and are the y Ina g <br /> agreement? Mf Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) blank if none) <br /> 6. Is a location survey required? (see reverse) Wes 0 0 Don't know <br /> 7. Is this to correct a violation? ❑Yes o <br /> APPI.iCATION MUST BE SIGNED <br /> 545-112(41011) (Continue on Back) -0, -0. -0. <br />