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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Susie and Dieter Brandschied <br /> E Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6158 Knollwood Dr <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 835-5984 sfbrands @wisc.edu ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Eric Donovan TDS Custom COnstruction ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1431 Northern Ct <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Madison,WI 53703 <br /> PHONE PHONE ❑ Site Plan approval from <br /> (608) 251-1814 applicable township. <br /> • <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ericd @tdscustomconstruction.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation of property <br /> PARENT PARCEL NUMBER: CURRENTZONING: ACREAGE: <br /> ❑PARCEL 042/0509-063-0551-1 R-1 DCPREZ-0000-01819 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> TO5NRO9E 6 1/4. NE of the SW 1/41/4. ❑ Driveway permits <br /> ADDRESS: (state, county, town) <br /> 6158 KNOLLWOOD DR <br /> CSM: LOT 51 SUBDIVISION BLOCK/LOT ❑ Sanitary permits <br /> RAVENOAKS (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Construct new screen porch ❑ Zoning District <br /> . EThis project is a new building or structure. <br /> ❑ Permitted Use? <br /> ig This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> FIEWER aEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 15.0 1.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: <br /> 1 22.0 ,$, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 122.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ "+ -► --► ♦ ♦ $ 22,500.00 <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 ENo ❑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) [Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? Des ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ -+ -+ <br /> 545-112(4/05) <br />