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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Raymond Maurer ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 7399 County Trunk Hwy PD/McKee Road,Town of Verona,Wi <br /> Variance(#_ ) <br /> HOME PHONE— CELL PHONE E-MAIL ADDRESS <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Midwest Homes Inc Midwest Homes Inc ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 925 Watson Ave <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Madison Wi 53713 <br /> PHONE PHONE El Site Plan approval from <br /> (608) 271-4900 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> info @MidwestHomeslnc.com El 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 0661903 19 S0 20 A -,7 Z� , y frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: ea <br /> Verona 4 IS y4: ■J )i +/4+/4. 1-1,0 g ..El Driveway permits <br /> ADDRESS: (state,county,town) <br /> 7399 County Trunk Hwy PD/ McKee Road <br /> CSM: LOT SUBDIVISION BLOCK/LOT CI Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> new 2 car garage addition ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> 151This 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 /> 14.0 1.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shot-eland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ EroSionControl permit <br /> BASEMENT: 1ST FLOOR: <br /> 844.0 j TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 844.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: Q and available options. <br /> $ <br /> (Please round to nearest dollar) '. "♦ - - 38,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes Ipslo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Elves no ['Don't know <br /> Q 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 property in the past 5 years? ❑Yes ✓DVo <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 EiVo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓❑Nlo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ -► -► <br /> 545-112(4/08) <br />