Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Benjamin C. Staats <br /> ❑ Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 7279 Legacy Dr, Middleton, WI 53562 Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS �/ <br /> (662) 889-0381 Bcstaats @Iive.com LY Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> N/A N/A ❑ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ilSetbacks <br /> PHONE PHONE ❑ Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dan..wl.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑ PARCEL R 038/0708-092-2745-0 A-1 0.966 frontage drawn to scale. <br /> NUMBE <br /> TOWNSHIP: SECTION: <br /> Middleton NW /4: NW 1/41/4: ❑ Driveway permits <br /> ADDRESS: (state,county,town) <br /> 7279 Legacy Dr, Middleton, WI <br /> ❑ Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public,private) <br /> Le•ac Hi•hlands Lot 5 <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: <br /> Exterior Deck Addition <br /> his project is a new building or structure. <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> ❑SEWER SEPTIC <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 9' 3" 1 <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> TOTAL SQUARE FOOTAGE: <br /> 2ND FLOOR: 3RD FLOOR: <br /> 400 sq ft <br /> ESTIMATED CONSTRUCTION COST: <br /> (Please round to nearest dollar) '-e• —' "♦ • ♦ $ 3,900 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes lM o ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes lir)lo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? .... ❑ es No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? W IY <br /> Wes ❑No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blanlyf none) <br /> 6. Is a location survey required? (see reverse) ❑Yes lip ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes VirNo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4108) (Continue on Back) —► —► <br /> —► <br />