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0 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMELIT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME BAY VIEW HEIGHTS, INC. <br /> OWNER ADDRESS (Number.Street,City,State,Zip) ❑Zoning Status; CUP; <br /> 909 CHARLES LANE STOUGHTON,WI 53589 Deed Restriction; CSM <br /> HOME PHONE I CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (608)873-7725 (608)575-7430 BAYVIEWHOMESALES@HOTMAIL.COM ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> BRYAN FOLZ BAY VIEW HEIGHTS,INC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 5610 REINER RD 909 CHARLES LANE <br /> (City.State.Zip) (City,State,Zip) ❑ Setbacks <br /> SUN PRAIRIE,WI 53590 STOUGHTON,WI 53589 <br /> PHONE PHONE ❑ Site Plan approval from <br /> (608) 345-2581 (608) 873-7725 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> BRYAN @STERLINGPROPERTIES.ORG BAYVIEWHOMESALES @HOTMAIL.COM ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑PARCEL 0610-262-9000-3 R-4 26.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> DUNN 26 +/4: NW 1/41/4: SW ❑ Driveway permits <br /> ADDRESS: 915 CHARLES LANE STOUGHTON, WI 53589 (state, county, town) <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 765 14 BAY VIEW (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 14'X56'MOBILE HOME/12'X14'DECK W/4'X4'STEPS/(2)4'X4'DECKS W/(2)4'X4'STEPS ❑ Zoning District <br /> This 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 r)EPTIC (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: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: <br /> ❑ ErosionControl permit <br /> 0.0 1 032.0 4 TOTAL SQUARE FOOTAGE: j (slopes, disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 0.0 0.0 <br /> 1 ,032.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: . ♦ ♦ -► and available options. <br /> (Please round to nearest dollar) $ 2,500,00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes igho ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ONo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? JYes ❑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 MINo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes NI No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -■ � <br /> i <br /> 545-112(4/08) ) -* <br />