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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE _ /' <br /> 4 <br /> OWNER NAME <br /> Allan & Mary Vervoort <br /> ONER ADDRESS (Number,Street,City,State,Zip) l�Zoning to UP; <br /> W <br /> 7626 Welton Drive Madison, WI 53719 Deed Re tion;CSM /0 0 S/ <br /> HOME PHONE CELL PHONE Variance(# ) <br /> E-MAIL ADDRESS <br /> (608) 833-9236 Site Plan drawn t scale <br /> AGENT INFORMATION �CONTRACTOR INFORMATION and includenSions <br /> 60 AGENT NAME CONTRACTOR NAME ���/// <br /> Jason Franzen Hart DeNoble Builders, Inc 'Site Plan includinatio <br /> AGENT ADDRESS CONTRACTOR ADDRESS ,rr "'_ <br /> 7923 Airport Road 7923 Airport Road <br /> (City,State.Zip) (City,State,Zip) Setb �0723-70A- <br /> /`2 /` <br /> 0% <br /> C <br /> Middleton, WI 53562 Middleton, WI 53562 <br /> PHONE PHONE Site Plan p r from /VA <br /> (608) 831-4422 (608) 831-4422 applica rvrii . All- <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jfranzen @denoblebuilders.com 4 Floor plans to�c,�te • <br /> , / <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) `/ 4 <br /> PARENT PARCEL NUMBER: CURRENTZONIN ACREAGE �/ Elevation of p erty <br /> ❑PARCEL 070729285100 ,r <br /> NUMBER A �i 5.09 frontage dr n to scale. <br /> TOWNSHIP: SECTION: <br /> Cross Plains 29 /4: NW //: NW 'Drivewa�(Ip ni <br /> ADDRESS / (state, co ty, own <br /> 9 k S'/ M I A, c a / 0 I " /e d q CI TX CSM 12,785 LOT 1 SUBDIVISION BLOCK/LOT (publa ' =1 <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: d r– �� <br /> New single Family Residence Co v F./+- /0 ,r , Se 4 c0`- le ,, Zoning District /T <br /> O This project is a new building or structure. g , <br /> Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. S <br /> SANITARY SERVICE: PERMIT NUMBER: —2CRU_-I Address <br /> EWER PIEPTIC 13,201,500,061 „ ,,- .• .. <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) ,�t.-- <br /> 26.0 1.0 Aa1 Wetland/Floodplain/ <br /> Shoreland attar-1=P <br /> AREA TO NEAREST SQUARE FOOT: —■ <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porch: <br /> BASEMENT: 1ST FLOOR: A ErosionControl permitTA <br /> 2,200.0 3,797.0 4, TOTAL SQUARE FOOTAGE: (slopes,disturbance, V(vI if <br /> 2ND FLOOR: 3RD FLOOR I Illn /access) T - <br /> 5,997.0 <br /> Review Location Survey i/ <br /> ESTIMATED CONSTRUCTION COST: and available options. / 15- <br /> (Please round to nearest dollar) '♦ ♦ ♦ '+ '* $ 375,000,00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ✓❑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 ✓❑No <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) ❑Yes ENO ❑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) —0. <br />