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• <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Kohn Enterprises LLC ❑zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> Deed Restriction; CSM <br /> 2002 Waunona Way Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)239-7570 george.kohn @weststarfarm.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION 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 UMBER. CURRENT ZONING: ACREAGE: <br /> 0 NP UMBER d /[ 611-0Y3-11100-8 11 Ag 40.00 frontage drawn to scale. <br /> TOWNSHIP: SECTION <br /> Pleasant Springs I/---s//.l;%: Sit/ Y41/4: fl Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2571 West Star Rd Cottage Grove, WI 53527 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> greenhouse ❑ Zoning District <br /> . 151This 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 induding basement) <br /> 15.0 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) I-, ErosionCQntrol permit <br /> BASEMENT: 1ST FLOOR: <br /> 9E 2) 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> CiS 2u ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: / QG and available options. <br /> (Please round to nearest dollar) -♦ -10 -'0. -0 -0. -0 $ a <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? ❑Yes EINo ❑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? QYes ❑No <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 ENo ❑Don't know <br /> 7. Is this to correct a violation? Efres ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ■ -+ <br /> 545-112(4/08) <br />