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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME JACK OESTREICH <br /> ..--- <br /> Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) eed Restriction; CSM <br /> 1784 HWY 73, CAMBRIDGE,WI 53523 Variance # ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS v,/".---- ........... <br /> (630)267-2632 JACKOEST @HOTMAIL.COM <br /> 0�/ Site Plan drawn to sca <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> SELF SELF i;11 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS 0 -' se.tic Z� <br /> • � <br /> (City,State,Zip) (City.State,Zip) 4Setbacks /0 0 <br /> 50 <br /> PHONE PHONE <Site P n p ov from N( F <br /> appli a ship. /�+ <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wl.us/) ' 1( <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 1/ Elevation of property I / <br /> D PARCEL 061234288750 A-1 EX 0.91 frontage drawn to scale. (6, <br /> NUMBER <br /> TOWNSHIP: SECTION: /� / , ! ', l <br /> CHRISTIANA 34 '/a: 'v ry 1�1�4: 'V I'J Drive y{p its Of/4- <br /> ADDRESS. 1784 HWY 73, CAMBRIDGE, WI 53523 j( stat ,c own) <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary permits <br /> �� �--- public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> GARAGE ADDITION 01 R r o r�'' S V /J Zoning District 4'-I o f <br /> DThis project is a new building or structure. r' f: f ke/Wv � p6`es f �Q <br /> / / Permi e se? /4 1L1 <br /> This project is an addition/alteration to an existing building or structure. "- <br /> SANITARY SERVICE: PERMIT NUMBER: Rural Ad e <br /> EWER [EPTIC (new/ ISti g) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 25.0 2.0 Wetland/ I odplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shorcdttachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> • E <br /> BASEMENT: permit <br /> ASEMENT: 1ST FLOOR: <br /> 6 0 j TOTAL SQUARE FOOTAGE: 4, (slo urbance, <br /> I fillin es ) <br /> 2ND FLOOR: 3120 FLOOR: <br /> Zeview Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ � 41m6.0, , CIF, and available options. <br /> (Please round to nearest dollar) Uv 4.--- <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? I Yes JAW ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ['Yes rinNo DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? s No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ['Yes / ' to <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 Elo DDon't know <br /> 7. Is this to correct a violation? [Yes DNo <br /> 3 (/ 1 , <br /> APPLICATION MUST BE SIGNED <br /> sas-,iz is oa (Continue on Back) -+ -► -+ <br />