Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Matthew and Jacquelyn Hennek Wing Status;CUP; <br /> OWNER ADDRESS (Number.Street,City,State,Zip) �� «-Deed Restriction;CSM <br /> 1160, Washington Rd, Stoughton, WI, 53589 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (205)242-5446 matthew.hennek maWAm 2 6 2( <br /> @9 �Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dave Cook(The CotfmciedefeititykANtan& )kh En including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> N3927 County Highway J <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Monroe, WI, 53566 <br /> PHONE PHONE Ill Site Plan royal from <br /> (608) 558-8171 appli etow : ip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @thecottageworks.org •• .• - <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn D Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> D PARCEL BER 002/0512-073-8660-0 A2(2) 2.14 frontage drawn to scale. <br /> NUM <br /> TOWNSHIP: SECTION: <br /> Town of Albion 7 I/,. SW +/1/: NW li Dnvewa. •ermits <br /> 'ADDRESS: (StatCOUnty, n) <br /> 1160 Washington Rd, Stoughton, WI 53589 <br /> CSM: LOT SUBDIVISION BLOCK/LOT n Sanita ermits <br /> (pu c,private) <br /> 12,681 2 <br /> PROPOSED PROJECT INFORMATION <br /> IVY AFFIE1K <br /> PROJECT DESCRIPTION: <br /> Accessory Building: 12 ft x 14 ft Prefabricated Shed to be placed on gravel foundation _-`. _ � <br /> eve <br /> . 0 This project is a new building or structure. <br /> I�•�se7 <br /> ❑This project is an addition/ Iteration to an existing building or structure. 4st?� <br /> SANITARY SERVICE: PERMIT NUMBER: ` -: <br /> EWER EPTIC # e<ttse` <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not' cluding basement) ' _ _ �, <br /> 11.0 1.o <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: + ? <br /> 0.0 168.0 j TOTAL SQUARE FOOTAGE: j . ,. a nc� <br /> 2ND FLOOR: 3RD FLOOR: I ! � � <br /> 0.0 0.0 168.0 <br /> ESTIMATED CONSTRUCTION COST: i 3M• �` <br /> (Please ) -• -� -• -• $ 3 603.00 ,70y4a ... .-, .� . <br /> Please round to nearest dollar <br /> 3,603.00 �y - <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [7Yes ✓❑No DDon't know <br /> 2. Is there a wetland oir floodplain on or near the property? Dyes ✓DNo DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? <br /> Dies ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes MIN() <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) Dies ✓❑No DDon't know <br /> 7. Is this to correct a violation? Dyes ✓DNo <br /> Fee - 4 so O .0-7 54 1 r G APPLICATION MUST BE SIGNED <br /> �O O= k(Continue on Back) ■ -• -i <br /> 545-112(4/08 <br /> 4 co ,,,9). , co <br />