Laserfiche WebLink
5) i' z___c›-o015 00,5611 <br /> ZONING PERMIT SUPPLEMENT to Web-App # <br /> MIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION Cu OMER TO PROVIDE <br /> OWNER CNAA,M,E, 1 <br /> I�r 1 -Ve Y � H' LQ ' ` 1 V Zoning Status;CUP; <br /> OWNER ADDRESS (Num eet,City,State Zip) <br /> 155(2- \j\ji2 ton es Deed Restriction;CSM <br /> •MEP 'NE CELL PHONE yriance(# ) <br /> ©, C (G ^ ' •1 E-MAIL ADDRESS <br /> SJ e Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION find includes dimensions <br /> MIA.ME CONTRACTOR NAME <br /> �Y� i men t 61 Dew i "/c <br /> r 2 tte Plan including location DD S CONTRACTOR ADDNS <br /> f well/septic <br /> IP <br /> ,State, ') /City,State, �p) Setbacks <br /> 1.4 ., idtk. to i PHO _ <br /> PHONE <br /> CPI�� I�\ Site Plan proval from <br /> lle'U 4-3i (0 jQ) pli e township. <br /> E-MAIL DRESS E-MAILADDRESS <br /> Miec 6 VyI St=i 0 '•ezviZiop-afr, corn loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENTZONI ACREAGE: E vation of prope <br /> ❑PARCEL �J ff,,�� �}` <br /> NUMBER a`- --n3 _C�J 2U ZJ f ontage drawn to Cale. . <br /> TOWNSHIP:^ SE'(�/}LION: 111 �v Imo, l II <br /> rbtJ(Co /2 /4. +/4/4. 1-_ 911veway p mits <br /> ADDRESS: ���� state,county,to ��!•.410 ° <br /> _') Cito .e-i(i Pci i2(Spnitary peiits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 't O ublic,privates <br /> PROPOSED PROJECT INFORMATION AFF REVIEW <br /> PROJECT DESCR)PTION: 'j Th, • <br /> K.e),, ec f,n -1' 'L� 0y) — 4-�C j(cefce iq/ � oni g ust ict <br /> .,This project is a new building or structure. <br /> P3,11 ' ed fuse? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: - ° •, <br /> EWER JEPTIC W 3 '�) <br /> HEIGHT IN FEE J���, NUMBER 2015—STORIES: (Not including basement) 1 <br /> c9 I Il tland/Floodptaitd U <br /> AREA TO NEAREST SQUARE FOOT and (8tta" ' <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEME� i� 1ST FLOOR:_ P (� f° cxlContfot •° i ill <br /> �1 �Q 4 TOTAL SQUARE FOOTAGE: 4 ( e i a..° { + <br /> Al 4LIVAll <br /> 2ND FLOOR: 3RD LOOR: 4/ ' access)• <br /> ^? l I ! Review Location Surrey <br /> ESTIMATED CONSTRUCTION COST: C __S <br /> (Please round to nearest dollar) 'i "* -♦ t -+ $ 3 lO and available <br /> 1. The property is within 300 feet of a stream or 1000 f et from a pond or lake? es o ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the prope ? Res <br /> o Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Yes o <br /> 4. Has there been a zoning permit issued for this prop rty in the past 5 years? ❑Yeo 014 <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (le a blank if no ) <br /> 6. Is a location survey required? (see reverse) es ['Don't know <br /> 7. Is this to correct a violation? [Yes o <br /> eel APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) -* -► -► <br /> I <br />