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. .. _ <br /> •i • <br /> DANE COUNTY ZONING 01VISION • • <br /> •• •-: ',r '+ <br /> dill,COUNTY WILDING.RA 116 • <br /> 210 MARTIN WTHeR icoic a.ILVD. • . .." <br /> MADISON. WISCONSIN S37034342 . ,; , ‘' <br /> • <br /> PHONE 2664266 PAX 267-1540 ,... ..,L. , . :.. . <br /> COsiei athiaLcadangitl . <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> • . <br /> , <br /> 1. LANDOWNER: 1_, a I a Sri Ili W ASINT: <br /> ADDRESS: , hr*if 0 <br /> itte.d 2 10 . . <br /> PHONE: ,,0 47. ../0414, .. - he PHONE: <br /> BUM.: EMAIL: <br /> 2. TYPE OF PROJECT: A./. h i e ,T4If\C-41`-jfr 411 <br /> ESTIMATED COST OF CONSTRUCTION: $ 4,,A '7 57966 (Structwi phs mechanicok.) <br /> 3. ADDRESS OF PROJECT,IF KNOWN: Bet goittrei L/u), <br /> 4. LOCATION OF PROJECT:w M si 14 I‘e1/1 <br /> roitskap,SEC170N,1/4 1/4 <br /> TAX PARCEL AVNER <br /> 5UNDIVISTOA IC*C541#(Certified Sarney Alqg IF ANY: IO . ' mot* a <br /> 1,01AVAIBER"ANY: I 0 F'3 <br /> , <br /> 6. ZONING DLSMICT. — <br /> 7. SITE PLAN: *A site plan nowt be draw to sci*showing the lot lines and kt dimensions,the locale,' <br /> and size of al/existirg and proposed buiklings or additions and their diatoms,from <br /> lot hut If the lot is not served by public saner, the kcation and size of the on-site <br /> septic system and the location of the sell shail be shown on the plan. . <br /> _ Exoespk of e Ste Plan en reverse. <br /> 8 FLOOR PLANS AND ELEVATION VIEWS(front, skies,roar): A cepy wil 1 be apt in Zen*Division fast <br /> Eiromples of Floor Pkas end <br /> 1314M__, P ;\/et 4— ---. <br /> 9. PLOLIC SEWER OR PRIVATE SEPTIC SYAE/A7 <br /> STATE SANITARY PERMIT NEEDED? V N IF YES,PERMIT• •_Ala -- 213 I <br /> ArfROVAL FOR MAINS BEDROOM OR ' 25%AREA NEEDED? y€1 IF YES, PROVIDED? Y <br /> 10. DRIVEWAY(or OMrt or Amiss)PERMIT NEEDED? Y/c2 IF YES, PROVIDED? Y 41) <br /> Many Tams require a Drimnowy Permit County Highway Deportment or WDOT permits may be required for <br /> drivenwys with access to a County,State o r lAS Highway <br /> 11. ?. y i <br /> 12. OTAL AREA OF DISTURBANCE(SquorAFWWWWfest) 19°4 <br /> siciRELANb <br /> • <br /> Y/ETLANDS Y Q <br />