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Town of Mazomanie <br /> 711 West Hudson Street <br /> Mazomanie, WI 53560 <br /> 608-795-2120 <br /> twnmazo @gmail.com <br /> Site Plan Approval Form <br /> Name: Irma Kliebenstein <br /> Address: 10770 F Mathewson Rd <br /> Parcel #: 034/0806-033-9220-9 <br /> Zoning : RH-1 DCPREZ-0000-03526 <br /> Acres: 2.000 <br /> Site Plan Approval: <br /> Ala Li <br /> By Land Plan Commission: � Ld Date: A &, 2015 <br /> Rick ipp rfurth,A an <br /> By Town Board: - • Date: Aa r-A--a-3, 2015 <br /> 1 <br /> Fred Wolf, • airman <br /> Conditions: <br /> The site plan for extension attached. <br /> The applicant will receive 2 copies of this form. It must be completed prior <br /> to application for a county zoning permit and submitted both to Dane <br /> County Zoning (608-266-9083) <br /> https://www.countyofdane.com/PLANDEV/zoning/ and to the Town of <br /> Mazomanie Building Inspector (Tracy Johnson (608-444-0372) when <br /> applying for a building permit. <br />