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SUPPLEMENT to Web-App# <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Blue Star Dairy <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 7502 Patton RD Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)219-7039 ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Chris Aultman Morton Buildings,Inc ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 411 E Leffler ST 411 E Leffler ST <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Dodgeville,WI 53533 Dodgeville,WI 53533 <br /> ❑Site Plan approval from <br /> PHONE (608) 574-5987 PHONE (608) 935-2384 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> chris.aultman©mortonbuildings.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 064/0909-103-9000-2 A-1 EX 39.30 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Vienna Township 14: sw '/41/4: sw ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 7502 Patton RD <br /> CSM: LOT SUBDIVISION BLOCK/LOT El(public, permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Milk House ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> o This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: 'PERMIT NUMBER: ❑ Rural Address <br /> EWER [EPTIC (new/existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 12.0 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionControl permit <br /> 240.0 j TOTAL SQUARE FOOTAGE: + (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 240.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -+ ♦ ♦ -+ ♦ ♦ 30 000.00 and available options. <br /> (Please round to nearest dollar) , <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ao 90on't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ,/No 9Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? /❑Yes No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes a <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 Epo ['Don't know <br /> 7. Is this to correct a violation? [Yes ON <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ■ —P. <br /> 545112(4A8) <br />