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:ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME Dale Marsden <br /> ['Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 2614 Riverholm Rd <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)838-3992 (608)609-0618 marsdenhoney @yahoo.com n Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Hoeper Green Power ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 414 N Madison St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Cuba City WI 53807 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 732-6712 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> shane @hoepergreenpower.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation of property <br /> PARENT PARCEL NUMBER: CUR ENTZONIN )) ACREAGE: <br /> ❑ <br /> NUMBER ER �G lv `/ 2 (�?A--* P. 1_ git - . j . L frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Dunn /tI 'A: Iv c_ '/a'/a: /pp ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2614 Riverholm Rd., McFarland, WI 53558 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 8.16 kwDC PV array ❑ Zoning District <br /> • FA This project is a new building or structure. ❑ Permitted Use'? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER FrEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 1 7/ ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionControl permit <br /> 4. TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: ti 4`� <br /> filling/access) <br /> j <br /> •�� 4l <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ --► ♦ d / �O a and available options. <br /> (Please round to nearest dollar) a <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Elves []No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes I No ❑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 iaect -inetterpest-' .years? Elves [ No <br /> 5. Is this project associated with a rezone/CU <br /> VI nce(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Elves QNo ['Don't know <br /> 7. Is this to correct a violation? LAY...1...8...2015 Elves ONo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) DAME COI;N?Y PLANK 3&OEVELOPMEN7 (Continue on Back) -+ —► -÷ <br />