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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME Gary J Theobold <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6276 Devonshire Lane,Sun Prairie Wi 53590 <br /> Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS ) <br /> (515)710-3751 (515)710-3751 garyjohn @yahoo.com <br /> Q Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> p Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: Elevation of property <br /> ❑PARCEL 081002115663 R-1 0.49 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Burke '/a: '/a'/a: ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 6276 Devonshire Ln, Sun Prairie Wi 53590 ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> Foxmoor Hills (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Building a lawn storage shed ❑ Zoning District <br /> . This project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER rr ,, PTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 9.2 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: r--1 ErOSionControl permit <br /> TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 160.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: - and available options. <br /> (Please round to nearest dollar) $ �y U <br /> / <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑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? JYes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? :Yes ✓INo <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 Dslo ❑Don't know <br /> 7. Is this to correct a violation? [Yes Olo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -► - <br /> 545-112(4108) <br />