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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Melanie Carpenter <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street.City.State.Zip) Deed Restriction; CSM <br /> 6612 Patton Road,Waunakee,WI 5357 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)205-7917 melacarp24 @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dave Budden Meigs Inc. ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> P.O.Box 412 P.O.Box 412 <br /> (City.State.Zip) (City,State.Zip) ❑Setbacks <br /> Black Earth,WI 53515 Black Earth,WI 53515 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 767-2729 (608) 767-2729 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com dave @meigsbuilds.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑PARCEL 064/0909-342-8690-1 A-1(EX) 5.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Vienna 34 /4: +4�/4: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 6612 Patton Rd, Waunakee, WI 53597 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Storage Building ❑ Zoning District <br /> . OThis 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 Address <br /> EWER ••(( '' PTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 20.3 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: 2,520.0 4, TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 2,520.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ -+ ♦ — —' — $ 70,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies INN() ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes allo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Dies ENO <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes ONo <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) Elves No ❑Don't know <br /> 7. Is this to correct a violation? Elves EINo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ ■ -♦ <br /> 545-112(4/08) <br />