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DANE COUNTY ZONING DIVISION <br /> OZTY couPMTY IrM11a)*.U 11I <br /> ti0 MARTIN UM*70M,R./LVO. <br /> MADISON,waaO INDIN E1709-3y11 <br /> • <br /> PHONE III.4111 FAX 117.1010 <br /> ZONING PERMIT CH C LIST <br /> PLEASE FILL IN AS MUCH INFORMATION Al POSMILL <br /> 1. LANDOWNER= V gE.I121b l ittrAGS NEW <br /> ADDR AESS= DDRESM= <br /> PbDls:We 1%1"1 5311 e• <br /> MOPE= tont I Z?,I�• :S1 Ism MOPE' <br /> EMAI LI <br /> EDAM: n <br /> �a I.I i 1�. a.sa^ it <br /> Z. TYPE OF Fno�cr= 9 � � ir+�c�"'�P�'r� <br /> ESTIMA9�COST of CONSTRUCTION: <br /> 3. ADDRESS of PROJECT,sF KNOWN: <br /> pL 1. (:)624C) <br /> 4. LOCATION CF PROJECT= <br /> 719111N5liVe 5872.4 ►t 1/41/4 <br /> TAXPAAlC1E WANE <br /> s 5 <br /> morvruav OR CSAIV Certified 5trwy Ann: <br /> LOT MAUNA IF ANY: <br /> 1\ <br /> 6. ZOOMS DISTRICT= <br /> 7. 5171 RAN= *A site plan wet be d nten to sada___ t&lot MOs mid lot o <br /> The bcallo <br /> and size ofal existing and proposed boler °r additions and Moir distances fray <br /> — lot king lYthe lot Is rat Arend bypub C nnrwn tho location and size of the on• Rte • <br /> septic sy s em and Ms&orlon of Me WI sh Nbe A SNIT an Me <br /> F_- of a SAN flee ae rsrre m <br /> S FLOOR PLANS AND ELEVATION VIEWS(fruit. skis, reeds r): A await be kW M Z ohision film <br /> EraJ 'D of plow Mao anal Ekvationo ettook od. <br /> 9. PUIIIC SEWER OR PRIVATE SEPTIC - <br /> STATE SANITARY MET IMOD? ' IF 1U. MATT* <br /> APPROVAL FOR AMINO REDROOM OR PSG AREA PEA? Y IF YES.PROVIDED? • / <br /> 10. DRIVEWAY(rr°kart w Asesy PERMIT PEM? Y N IF YES, PROVIDED? Y . <br /> Alcor Town e o Driveway PMro Ciro?y1S'Mnq� or WDOT rrrrF' <br /> de/w rapr aWth mast to a Otonty.State or LAS iilsharty <br /> 11. SFIORA.APD? Y <br /> PLOODP.APN? Y N WETLANDS Y ej. <br /> !V.1.1 .St.K i mien scam mums fast) <br />