Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jameson Living Trust, Joseph H. & Deborah C <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 8597 County Road A Belleville WI 53508 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)832-6803 (608)212-9357 primrosepete @live.com <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> OWM' O1Nner ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> PHONE PHONE El Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS � <br /> YaM�tb�S((�� <br /> cale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: E e atl <br /> f property <br /> rty <br /> Q PARCEL 048/0507-222-8060-0 A 1 (EX) 2.50 , fr ng& awn to sca le. <br /> UMBER <br /> TOWNSHIP: SECTION: <br /> Primrose 22 +%. NE %1/4. NW ❑ Driveway permits <br /> OMIY P `ve dIIEVESLOSIENT ADDRESS: <br /> 8597 County Road A <br /> ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 3,516 3 (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Accessory Building for gardening and lawn care equipment(unheated) ❑ Zoning District <br /> a This project is a new building or structure. <br /> ❑ Permitted Use? <br /> 11 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ RuraIAddress <br /> EWER PEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 11.0 1.0 Cl We and/FloodplaiU <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland'(attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErosionControl <br /> BASEMENT 1ST FLOOR: Perms <br /> 0.0 320.0 + TOTAL SQUARE FOOTAGE: + (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 0.0 0.0 320.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ and available options. <br /> (Please round to nearest dollar) $ 5,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes al. ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes no <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes Jslo <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 ❑No ['Don't know <br /> 7. Is this to correct a violation? :Yes ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) —► <br />