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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME BAY VIEW HEIGHTS, INC. <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 909 CHARLES LANE STOUGHTON,WI 53589 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)873-7725 (608)575-7430 BAYVIEWHOMESALES @HOTMAIL.COM ❑Site Plan drawn to scale <br /> AGENT INFORMATION 1 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/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <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: S ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 715 PIKE LANE STOUGHTON, WI 53589 <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 765 14 ❑Sanitary permits <br /> F BAY VIEW (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF-REVIEW <br /> PROJECT DESCRIPTION: <br /> 14'X66'MOBILE HOME/8'X12'DECK W/(2)4'X4'STEPS/4'X4'DECK W/4'X4'STEPS ❑ Zoning District <br /> . r This project is a new building or structure. J Permitted'Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER rEPTIC (new/existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 15.0 1.o ❑ Wetland/l=loodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ Erosion COMroI permit <br /> BASEMENT 0.0 1ST FLOOR: <br /> 1 ,084.0 V , TOTAL SQUARE FOOTAGE: y, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 0.0 1,084.0 D Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) -* -* ♦ --► $ 2,500.00 <br /> pseI4rrref- - (31.30 <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 Eto ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes o <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 51No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes IN <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► - <br /> 545-112(4/08) <br />