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DCPZP-2015-00075
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DCPZP-2015-00075
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5/6/2015 3:26:43 PM
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4/23/2015 1:22:37 PM
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Zoning Permits
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DCPZP-2015-00075
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DANE COUNTY ZONING DIVISION <br /> CITY COUNTY BUILDING,RM 116 <br /> 230 MARTIN LUTHER KING,IR.BLVD. r <br /> MADISON.WISCONSIN 53703-3342 ee t:0; <br /> :1 <br /> PHONE 266-4266 FAX 267-1540 <br /> www.countvofdane.com/zoning <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> 1. LANDOWNER: Ve- ' i �� • i1 U.C. A ENT: <br /> ADDRESS: v • :•l.�. # ,1 ADDRESS: <br /> rnir ;°5.1, (3 <br /> i - b� PHONE: <br /> PHONE: JAI <br /> EMAIL: EMAIL: <br /> � <br /> 2. TYPE OF PROJECT: 1\- • <br /> ESTIMATED COST OF CONSTRUCTION: $ 111 C0C9 + tructrre plusmechanica/s.) <br /> CT IF KNOWN: e 1\Vp c <br /> 3. ADDRESS OF PROJECT, <br /> 4. LOCATION OF PROJECT: <br /> TOWNSHIP,SEC7ION,1/41/4 <br /> TAX PARCEL NUMBER z <br /> SUBDIVISION OR C541#(Certified MopJ,IF ANY. S e . C. '6.:i LOT IVUMBER,IF ANY: <br /> t <br /> . <br /> 7. SITE PLAN: *A site plan must be drawn to scale showing the lot lines and lot dimensions,the location <br /> and size of all existing and proposed buildings or additions and their distances from <br /> lot lines. If the lot is not served by public sewer, the location and size of the on-site <br /> septic system and the k cation of the well shall be shown on the plan <br /> Exan Ie of a Site Plan on reverse. <br /> 8 FLOOR PLANS AND ELEVATION VIEWS(front, sides, rear): A copy will be kept in Zoning Division files <br /> Exagp✓es of Floor Plans and Eletntions atfachsd. <br /> 9. PUBLIC SEWER OR PRIVATE SEPTIC -I ? <br /> Pw - <br /> STATE SANITARY PERMIT NEEDED -N IF&))PERMIT it.__13 --IlOD-35'APPROVAL FOR ADDING BEDROOM OR> 25%AREA NEEDED? Y'lam) IF YES, PROVIDED? Y <br /> 10. DRIVEWAY(or Culvert or Access)PERMIT NEEDED? Y/ IF YES, PROVIDED? Y/Q <br /> Many Towns require a Driveway Permit;County Highway partrnenf or WDOT permits may be required for <br /> driveways with access to a County,State or US Highway <br /> 11. SHORELAND? Y w FLOODPLAIN? Y O WETLANDS Y( )i.NT <br /> 12. TOTAL AREA OF `LAND DISTURBANCE(Square feet) <br />
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