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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Erik & Tara Tomter <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 4319 Hawk Trl,DeForest,WI 53532 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)228-5152 ejtomter @hotmail.com ❑Site Plan drawn to scale <br /> AGENT IN FORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ['Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 068/0910-081-8745-0 R1 0.56 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Windsor B ' : NE 1 4%: N Ili ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 4319 Hawk Trl <br /> CSM: 12,6 11 LOT 2 SUBDIVISION BLOCK/LOT ['Sanitary permits <br /> 2 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCR PTION: <br /> UL&+.ipv,'lie,//� avp�.. .i1e a ❑ Zoning District <br /> . ii This 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 FIEPTIC (new/existing) <br /> HEIGHT IN FEET: / �� NUMBER OF STORIES: (Not including basement) <br /> 2- (0 1.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: p <br /> 384.0 j TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 384.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ and available options. <br /> (Please round o nearest dollar) $ 4,800.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Elves ✓❑Jo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes Nlo ❑Don't know <br /> 3. Have yoL 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 ✓❑No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a locat on survey required? (see reverse) [Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes LINO <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► —► —► <br /> 545-112(4/08) <br />