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s ' <br /> SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION iii. OMER TO PROVIDE <br /> OWNER NAME <br /> Richard J. & Christine V. Dusk <br /> S Zon g Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) D d Restriction; CSM <br /> 6766 Henry Rd.,Belleville,WI.53508 ria• e(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)770-8076 cvdusk @gmail.com • Sit- Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION a • includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Greg Neumaier Frey Construction&Home Improvement,LLC. • :it- Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of ell/septic <br /> 530 Park Ave. 530 Park Ave. <br /> (City,State,Zip) (City,State,Zip) ' etbacks <br /> Parairie du Sac,WI.53578 Parairie du Sac,WI.53578 <br /> PHONE PHONE U Site Plan app from <br /> (608) 370-1479 (608) 643-7914 applica ownship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> greg @freyconstruction.com greg @freyconstruction.com 0 ' loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p rty <br /> 0 PARCEL 040/0508-142-8295-2 R3 0.55 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: Al N 1E <br /> Town of Montrose 14 '/a: .--14€- 1/4'/a: . U Driveway p Its <br /> ADDRESS: (state, nty,town) <br /> 6766 Henry Rd., Belleville, WI. 53508 <br /> III <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary rmits <br /> pub!. ,private) <br /> PROPOSED PROJECT INFORMATION if STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Tearing off existing porch stairs and replacing them. oning District <br /> . ['This project is a new building or structure. • Permitt-. , <br /> rAThis project is an addition/ ration to an existing building or st uc re. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural ' :dress <br /> EWER EPTIC (new/:xisting <br /> HEIGHT IN FEET / NUMBER OF STRIES: (Not i uding b sement) <br /> ��^� ❑ Wetland/FI ain/ <br /> AREA TO NEAREST SQUARE FOOT: Shore! (attachment) <br /> (Outside dimensions including unfinished area,attached arages and above grade decks or porches) ❑ ErosiOnCOntrol rmlt <br /> BASEMENT 1ST FLOOR: <br /> ,, TOTAL SQUARE FOOTAGE: ,`, (slopes,di ante, <br /> 2ND FLOOR: 3RD FLOOR: s cl1 filling/a ) <br /> /0 <br /> ESTIMATED CONSTRUCTION COST: (� ❑ Re w Location Survey <br /> (Please round to nearest dollar) -� ♦ -0. -I. -+ -♦ $ I Q 0 and available options. <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 allo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Des ENO <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 ne) <br /> 6. Is a location survey required? (see reverse) Ekes ['Don't know <br /> 7. Is this to correct a violation? [Yes o <br /> -4 --7.s APPLICATION MUST BE SIGNED <br /> 545-112(4/08) 3:i <br /> (Continue on Back) <br /> ....c <br />