Laserfiche WebLink
--ift v <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Robert James Jensen <br /> ❑Zoning Status; UP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed es ion;CSM <br /> 6656 Twin Lane Rd,Sun Prairie,WI,53590 Varian # ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)335-0922 rjense2 @amfam.com ❑Site Plan raw scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and inclu a imensions <br /> AGENT NAME CONTRACTOR NAME <br /> ❑Site PIT i,ndliding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/ tic <br /> (City,State,Zip) (City,State,Zip) ❑SerekS <br /> PHONE PHONE ❑Site Pl oval from <br /> appli • nship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ❑Floor plansVeale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wl.us/) ❑Elevation f operty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 0911-253-9140-0 A-1 1.09 frontage wn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Bristol TO9NR11E 25 1/s: SW 1/41/4: SW ❑Drivew <br /> ADDRESS: (state, un ,to n) <br /> 6656 Twin Lane Rd, Sun Prairie, Wi 53590 <br /> ❑Sanita its <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 10,478 1 (publiq, • • at <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Screened in deck ❑ Zoning i Ct <br /> ❑This project is a new building or structure. ❑ permm��y,+,s� <br /> al This project is an addition/alteration to an existing building or structure. V �� <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> DEWER PEPTIC (new/e sQit,g) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 13.0 1.0 ❑ Wet'. •, rt•••lai <br /> AREA TO NEAREST SQUARE FOOT: <br /> Sho'" ; , :ttachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ Erosio I •I pe , <br /> mtit <br /> BASEMENT: 1ST FLOOR: 288.0 <br /> 4 TOTAL SQUARE FOOTAGE: j ( • . , . fiance• ' <br /> fll'• access) <br /> 2ND FLOOR: 3RD FLOOR: 288.0 J <br /> L Re I■►=ti <br /> CI Ai ∎ on Survey <br /> ESTIMATED CONSTRUCTION COST: <br /> ♦ ♦ ♦ ♦ ♦ ♦ an, - ail •'le options. <br /> (Please round to nearest dollar) $ 3,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes Jo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes J o )on't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes Dlo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes Z❑INo <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 'lo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> 5 z on Back) -► <br /> 4(Continue <br />