Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> A Onrlprte. ' 'A-Q`-/��eI' ❑ Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> N SnowC. ' ct e T ^y C O` � I Variance(# <br /> )HOME PHO ZONE E-MAIL ADDRESS <br /> (A' • 5-- , S E /,'Hie_ 44-`r6 ) b' 611"-''` ❑ 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 /> ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑ NUMBER 09/0 i3(0DI 0 h-(I 0, a c--/ frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Oi I (J l"C 0. r 1/4: ,/4%: ❑ Driveway permits <br /> ADDRESS: (state,county,town) <br /> 93(.2 Snow ski 1(1 _ <br /> CSM: LOT SUBDIVISION BLOCK/LOT ID Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION 44; AFF REVIEW <br /> PROJECT DESCRIPTION: f�. <br /> /10 ' x /(o' Gt - .( ,� C Zoning ist#K� <br /> ❑This project is a new building or structure. a imta (U <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> nSEWER (SEPTIC ( `w/ xiStirig) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> CI We f R 4i n/ .0' <br /> :`� E (attachment) <br /> AREA TO NEAREST SQUARE FOOT: %'` <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 7t-5/b flCE3 <br /> 11 #tt1f <br /> ASEMENT: 1ST FLOOR: , <br /> , <br /> 1 TOTAL SQUARE FOOTAGE: (slopes,, �rban , <br /> 2ND FLOOR: 3RD FLOOR: ftlling/a e <br /> 025.(0 sif P/ U R ; Survey <br /> ESTIMATED CONSTRUCTION COST: <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ • Vie,•InS <br /> ( ) 3 SCE , �. <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) El Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -o -+ -► <br /> 545-112(4/08) <br />