Laserfiche WebLink
' ZONING PERMIT APPLICATION ww.countyofdane.com SUPPLEMENT to Web-App # <br /> w <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME MICHAEL SCHMIDT <br /> OWNER ADDRESS (Number,Street,City,State,Zip) D Zoning Status; CUP; <br /> Deed Restriction; CSM <br /> 5309 SCHLUTER ROAD, MONONA WI 53716 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> CLASSIC CUSTOM HOMES 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 401 N. CENTURY AVENUE <br /> (City,State,Zip) (City,State,Zip) 12 Setbacks <br /> WAUNAKEE, WI 53597 <br /> PHONE PHONE MI Site Plan approval from <br /> (608) 850-4450 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> NICOLE@CCHOFWAUNAKEE.COM IN Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P rty <br /> 0 PARCEL 060/0706-044-9570-5 A2 10.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> VERMONT 4 +/4: SE %1/4. SE 0 Driveway permits <br /> ADDRESS: (state, county,town) <br /> 4617 OLD INDIAN TRAIL p Sanitary permits <br /> CSM. 4 103 LOT 1 SUBDIVISION BLOCK/LOT N/A N/A (public,private) <br /> PROPOSED PROJECT INFORMATION STAFFRE <br /> PROJECT DESCRIPTION: <br /> ADDITION ❑ Zoning District <br /> ❑This project is a new building or structure. ce � <br /> ❑ Rermitte�Usa7 <br /> Q This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ RUIi t °dreo <br /> EWER EPTIC <br /> 8,300,821 (new e stin PI <br /> i g <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) r x ` <br /> 22.3 2.0 0w ®IFIo � z.-1.1-,,t <br /> Sho a`nd (at i <br /> AREA TO NEAREST SQUARE FOOT: ;;` 4 <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) � � <br /> BASEMENT: 1ST FLOOR: �� � <br /> e a ® � <br /> 0.0 �3 1 ,919.0 � TOTAL SQUARE FOOTAGE: (S104 ®1 0 0� ,, <br /> t + <br /> 2 ,i(li cress) ' r :' <br /> 2ND FLOOR:901 .0 3RD FLOOR:0.0 ?,82.1 .0` J2 q <br /> ❑ Review lo4ti ` <br /> ESTIMATED CONSTRUCTION COST: - -+ - - - -�► '1'1:441411'6,4$01-01,i:&,=;,,:,, <br /> (Please r and to nearest dollar) $ 307 057.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes ONo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ['Yes EENo ['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 QNo Don't know <br /> 7. Is this to correct a violation? ['Yes ONo <br /> /�� `3 5 APPLICATION MUST BE SIGNED <br /> 545-112(4/08) Kk7i ✓ (Continue on Back) -♦ <br />