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DCPZP-2015-00256
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DCPZP-2015-00256
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5/26/2015 12:24:43 PM
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5/18/2015 12:58:39 PM
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Zoning Permits
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DCPZP-2015-00256
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DANE COUNTY ZONING DIVISION 4,3r4it.. <br /> CzTY COUNTY BUILDING. RM 116 • <br /> 210 MARTIN LUTHER KING,3R. BLVD. F : <br /> • <br /> MADISON.WISCONSIN 53703-3342 `�f <br /> PHONE 266-4266 FAX 267-1540 <br /> www.countyofdane.com/zoning <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> 1. LANDOWNER: �12.i2A C tC(l 110Irjts U-L'- AGENT: <br /> ADDRESS: t0 S Wive OA_ ADDRESS: <br /> YVICC <br /> PHONE: (I, )l 00 PHONE: <br /> EMAIL: EMAIL: <br /> 2. TYPE OF PROJECT: c _ V j C on n, 0 <br /> ESTIMATED COST OF CONSTRUCTION: .� J J j , I J.5 • (Structure plus mechanicals) <br /> 3. ADDRESS OF PROJECT, IF KNOWN: �t/ J I`�`� " <br /> 4. LOCATION OF PROJECT: n <br /> TOWNSHIP,SECTION,1/41/4 P I�t J <br /> TAX PARCEL NUMBER <br /> ------- --- <br /> SUBDIVISION OR CSM4#(Cerfrfiad 3urveyMip),If PINY.' <br /> LOT NUMBER,IF ANY: L_. ®� ( csi ) <br /> 6 ZONENG-DISiiIC-F: _ — --- — — --— — <br /> 7_ SITE PLAN: *A site plan must be drawn to scale showing the lot lines and lot dimensions,the location, <br /> and size of all existing and proposed buildings or additions and their distances from <br /> lot lines. If the lot is not served by public sewer, the location and size of the on site <br /> septic system and the location of the well shall be shown on the plan. <br /> Example of a Site Plan on reverse. <br /> B FLOOR PLANS AND ELEVATION VIEWS(front, sides, rear): A copy will be kept in Zoning Division files. <br /> Examples of Floor Plans and Elevations attached. <br /> 9. PUBLIC SEWER OR PRIVATE SEPTIC SYSTEM? V� ` y' <br /> STATE SANITARY PERMIT NEEDED? 1 /N IF YES, PERMIT# (��� -- 7 r l r <br /> APPROVAL FOR ADDING BEDROOM OR > 25%AREA NEEDED? Y/ IF YES, PROVIDED? Y <br /> 10. DRIVEWAY(or Culvert or Access)PERMIT NEEDED? Y IF YES, PROVIDED? Y <br /> Many Towns require a Driveway Permit;County Highway Department or WDOT permits may be required far <br /> driveways with access to a County,State or US Highway <br /> 11. SHORELAND? Y/E J FLOODPLAIN? Y e WETLANDS Y/ <br /> 12_ TOTAL AREA OF LAND DISTURBANCE (Square feet) <br />
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