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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 /> Joel Venske <br /> 19 Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1210 East Court St Janesville,WI 53545 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)698-6885 joelvenske @yahoo.com <br /> Q Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Troy Longhenry IN Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 4048 Lunar Dr <br /> (City,State,Zip) (City,State,Zip) d Setbacks <br /> Janesville,wi 53546 <br /> PHONE PHONE ❑Site Plana royal from <br /> (608) 290-8852 applicab township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ri Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usr7 Elevation of property <br /> 1:1 PARCEL PARCEL NUMBER: CURRENT ZONING: ACREAGE: eg <br /> PARCEL 0511-264-8565-0 a-2 C tt 5.25 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Dunkirk 26 1/4. st' 1/41/4. 1141 0 Driveway permits <br /> ADDRESS: (state,county,town) <br /> 376 Hannerville Rd <br /> CSM: LOT SUBDIVISION BLOCIQLOT Sanitary permits <br /> 12,486 1 lot 1 (public,private) <br /> PROPOSED PROJECT INFORMATION TAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> new single family home (I( U A c. Ig oning District <br /> ri 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 • ,.•res <br /> [EWER [EPTIC /_ t©r 5 ^Q (� l (new/e istin! <br /> HEIGHT IN FEET: 1 k NUMBER OF STORIES: (Not including basement) i <br /> 1.0 ❑ Wetland/ plain/ <br /> AREA TO NEAREST SQUARE FOOT:AREA d (attac ent) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ` ^n ❑ ErosionCOn !permit <br /> 47800-0 / /'� .1.75 }=E�/C 4, TOTAL SQUARE FOOTAGE: 4 Slopes,d urbance, <br /> 2ND FLOOR: l '✓``. 3RD FLOOR: f IIIng/a SS) <br /> 78 n <br /> Review Location Survey I C <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) - - –P ♦ ♦ -� $ 230,000.00 p <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? Efres JNo ['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 ONo ❑Don't know <br /> 7. Is this to correct a violation? Elves riNo <br /> • <br /> IC)O APPLICATION MUST BE SIGNED 41. <br /> -tr ., ... ,N ,..." r (Continue on Back) –► –► - <br /> 545-112(4/08) <br /> t <br />