Laserfiche WebLink
w <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Nathan Engelby <br /> OWNER ADDRESS (Number,Street,City,State,Zip) RECEIVED El Zoning Status; CUP; <br /> Deed Restriction; CSM <br /> 612 Westwynd Ct Apt A, Mazomanie,WI, 53560 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)795-4082 (608)335-3025 ( y <br /> .• Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Adam AGENTADDRE San ONTRACTORStfUCtlOn Inc p�ANN1NG&DEVEIDp Et* Site Plan including location <br /> of well/septic <br /> 1900 Prairie St 1900 Prairie St <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Prairie du Sac,WI 53578 Prairie du Sac,WI 53578 <br /> PHONE PHONE ❑Site Plan a ap or val from <br /> (608) 643-4667 (608) 643-4667 applicab township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS `/ <br /> adam©ganserconstructioninc.com adam@ganserconstructioninc.com Ig Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: property <br /> ❑PARCEL 090718393507 R-1 1.40 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • <br /> Roxbury 18 /4: SW 1/4/4. SW '4 Driveway permits <br /> ADDRESS: 1 <br /> Y1 (state, county,town) <br /> 4/ OU /41-1 \I 0 Sani permits <br /> CSM: LOT SUBD SION BLO OT permits <br /> p <br /> 11 (pu is rivate) <br /> PROPOSED PROJECT INFORMATION AFF REVIEW <br /> PROJECT DESCRIPTION: f' <br /> New Residential Construction IN) / © eCk- Q loning District <br /> . 4 This project is a new building or structure. <br /> Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. .°-..- <br /> SANITARY SERVICE: PERMIT NUMBER: '` awl R►ddress <br /> EWEREPTIC 13,201,500,082 (new/ 'sting) <br /> HEIGHT IN FEET: _ NUMBER OF STORIES: (Not including basement) <br /> -34:0 2.0 ❑ Wetiand/F plain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shorel d (attach nt) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ ErosionContr ermit <br /> BASEMENT: 1 ,432.0 1 ST FLOOR: 3,115.0 <br /> TOTAL SQUARE FOOTAGE: 4, csropes,di rbance, <br /> 2ND FLOOR: 3RD FLOOR: iling/acss) i <br /> 1 ,624.0 6,171 .0 <br /> ciReview Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ and available options. U <br /> (Please round to nearest dollar) $ 340,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes o Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes No IN Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? res No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Eyes 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 '4No ❑Don't know <br /> 7. Is this to correct a violation? Des r4No <br /> .-4 1 (J <br /> _2 U APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) ♦ —► <br />