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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 /> Brian Carlson <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Eioning Status; CUP; <br /> 6080 Templeton Dr. Waunakee, Wi. 53597 Deed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL l ADDRESS <br /> (608)824-1163 (608)513-1636 camperland @live.com !Elite Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Brian Carlson Fanning Construction ReSite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 6080 Templeton Dr 4042 Commercial Dr. <br /> (City,State,Zip) i(City,State,Zip) El Setbacks <br /> 6080 Templeton Dr. Waunakee, Wi. 53597 Janesville,Wi.53545 <br /> PHONE PHONE Site Plan approval from <br /> (608) 241-1636 (608) 295-2606 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> camperland @live.com kfanning @fanningconstruction.com ,Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: Elevation of property <br /> PARCEL ER 0810-191-8830-3 C-2 1.31 frontage drawn to scale. 1 <br /> TOWNSHIP SECTION: ,A A) <br /> Burke 19 1/4. NE 1/41/4: N Driveway permits 146 V" <br /> ADDRESS: tate, county,town) <br /> 5498 County Highway CV 53704 _ _ <br /> CSM: LOT I SUBDIVISION BLOCK/LOT �� rY permits �� - 2\il.".W1-5 <br /> 286 (public, •rivate) <br /> PROPOSED PROJECT INFORMATION �� �V <br /> PROJECT DESCRIPTION: STAFF� l�W <br /> Storage Building Li Zoning Dim (-- <br /> IXThis project is a new building or structure. <br /> Q Permitted Lice ? <br /> ❑This project is an addition/alteration to an existing building or structure. � 1�{ <br /> SANITARY SERVICE. PERMIT NUMBER: R ` � <br /> {3 s <br /> EWER [)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 23.6 <br /> 1.0 CI Vi ^tJandlF'IgcIplatnt` <br /> AREA TO NEAREST SQUARE FOOT: ttNnd <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: lfltl{�iW11 r0(�tetti3l �� <br /> 0.0 9,000.0 ,, TOTAL SQUARE FOOTAGE: 4, slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: ' <br /> 0.0 0.0 9,000.0 <br /> Loceal#n u�y <br /> ESTIMATED CONSTRUCTION COST: and e+re IbApltc►n <br /> ♦ -0 <br /> (Please round to nearest dollar) ♦ - --0 $ 230 000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes ONo Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ['✓Yes Jlo QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? I: Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ['Yes FNo <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 ONo ['Don't know <br /> 7. Is this to correct a violation? QYes 12 No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) –► –► <br />