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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> / <br /> PROPERTY OWNER INFORMATION CU OMER TO PROVIDE <br /> OWNER NAME <br /> Craig Schaning zo ng Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) D ed Restriction; CSM <br /> 160 County Road A,Cambridge,WI,53523 ariance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (262)490-1279 (262)490-1279 triturtle33 @yahoo.com ISI Si a Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION d includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Scott Nyland(S&R remodeling) S.a Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS well/septic <br /> 1525 S.Stoughton Road <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Madison,WI 53716 <br /> PHONE PHONE ❑Si Plan a•= •val from <br /> (608) 222-8044 tPli :. e township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Scott@srremodeling.com F •or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) levation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: IN <br /> ❑PARCEL 016/0612-363-9820-5 RH-2 DCPREZ-0000-06933 7.00 frontage drawn scale. <br /> NUMBER C <br /> TOWNSHIP: SECTION: ,J S a <br /> • Christiana 36 '/4: -sue 1/1/4: ' -' ❑Drivewa ermits <br /> ADDRESS: (stet oun ,town) <br /> 160 COUNTY HIGHWAY A, Cambridge WI, 53523 <br /> CSM: LOT SUBDIVISION BLOCK/LOT 1=1 Sanita permits <br /> 8,742 1 NA NA (p b. ,private) <br /> PROPOSED PROJECT INFORMATION APF REVIEW <br /> PROJECT DESCRIPTION: <br /> Convert attached 1 car garage to mudroom and add storage room above new mudroom. lining District <br /> . ❑This project is a new building or structure. .Permitted ? <br /> 0 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 0 RuralA s <br /> EWEREPTIC /e isti <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 22.5 2.0 Wetland/F1 lain/ <br /> Shorelan 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: rOS1onContro ermit <br /> 0.0 0.0 + TOTAL SQUARE FOOTAGE: ` (slopes,diSt ante, <br /> ,fi lling/a ' s) <br /> 2ND FLOOR: j 3RD FLOOR: <br /> '48$$'1 �� 0.0 j�'� S$ 0"" <br /> Li Revi Location'Survey ifOi <br /> ESTIMATED CONSTRUCTION COST: and available options, <br /> (Please round to nearest dollar) —' ♦ ♦ ♦ -+ —► $ 25,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes4'o ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o 4Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes ❑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 '4No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes 19 No <br /> r4/(0 to APPLICATION MUST BE SIGNED <br /> -1 (Continue on Back) ■ ■ —► <br /> 545-112(4/08) <br />