Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jeff Crosby ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City.State,Zip) <br /> 9352 Deed Restriction; CSM <br /> 352 Dunlap Hollow Rd <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)767-1400 (608)576-6860 jacrosby @tds.net ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Morton Buildings, Inc. ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 411 E Leffler St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Dodgeville,WI 53533 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 935-2384 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS ❑Floor plans to scale <br /> Chris.Aultman @MortonBuildings.com <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation of property <br /> PARENT PARCEL NUMBER CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 050/0907-314-9070-0 R-1 1.50 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • <br /> Roxbury 31 1/4: SE 1/41/4: sw ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 9352 Dunlap Hollow Rd Mazomanie WI 53560 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 11,286 2 (public, private) <br /> PROPOSED PROJECT INFORMATION <br /> 0 <br /> PROJECT DESCRIPTION: <br /> Garage/Shed $TAf 'REV1L <br /> Zoning District <br /> . 12 This project is a new building o,structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 0 Rural Address <br /> rIEWER n TI (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 16.0 1.0 0 Wetland/Fjoodplain! . <br /> A RZEA TO NEAREST SQUARE FOOT <br /> Shoreland (attachment) <br /> (Outside dimensions including t :i ustled area, attached garages and above grade decks or porches) <br /> BASEMENT: ,1ST F!_OO • <br /> ErosionCanfral permit <br /> 864.0 + TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> -- filling/access) <br /> 2ND FLOOR: 1 3RD F,_COR: 864.0 <br /> _ ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ -* ♦ ♦ ♦ --► $ 35,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ❑No NI Don't know <br /> 2. Is there a wetland or floodp.%:iin on or near the property? EYes ❑No ❑Don't know <br /> 3. Have you talked with the tcr:vnship about your project and are they in agreement? ❑Yes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes 151No <br /> 5. Is this project associated wi I a, ruzune/CUP/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? see reverse) [Yes ❑No ODon't know <br /> 7. Is this to correct a violation? Dyes 151No <br /> APPLICAUSIGE <br /> (Continue on TION BacMk)T BE—►S♦N E.+D <br /> 545-112(4/08) <br />