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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Wpb-App N <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jeffrey Becker and Katharine McClaren © Zoning Status; CUP; I <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 3145 Timber Lane.Verona,WI 53593 Variance(# �3 <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)848-2157 (312)953-5690 jeffreybecker @hotmail.com Q Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions , J <br /> AGENT NAME CONTRACTOR NAME N <br /> N/A Cleary Building Corp. <br /> Q Site Plan including locatio 4 k <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic ■ <br /> P.O. Box 930220 <br /> (City,State,Zip) I(City,State,Zip) 0 Setbacks 63,1' % _;' i <br /> Verona,WI 53593 <br /> PHONE PHONE 'A Site Plan approval from <br /> E�AAILADDRESS E-MAIL ADDRESS <br /> (608) 845-9700 -pplicable township. ,/� <br /> Q Floor plans to scale�/ <br /> PROPERTY/LOCATION INFORMATION (http://accsssdans.co.dane.wl.us/) Q Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ElPARCEL 062/0608-062-9630-8 RH-1 7.50 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION. <br /> Town of Verona j 6 �/4: SE WA: NW 4 Driveway permi <br /> • <br /> ADDRESS: state,county town) <br /> 3145 Timber Lane, Verona, WI 53593 r <br /> CSM: I LOT 1 I SUBDIVISION BLOCK/LOT Q <br /> Sanitary / 78- y <br /> 6,060 1 N/A N/A (public, 112 <br /> PROPOSED PROJECT INFORMATION 'STAFF REVIE <br /> PROJECT DESCRIPTION: / I ifur'l <br /> Shed 2 x , t x I J i t rs ('� X_Zoning District <br /> . Q �te' J This project is a new building or structure. � r' Permitted Use? 2 2 <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: -aRur. =•• - s <br /> DEVVER OPTIC (ne existin• <br /> / <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) 3O <br /> 10.0 1.0 (+'4,�0'rr ' oodplain/ <br /> ••. - attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) / '�rosionControl permit <br /> BASEMENT 1ST FLOOR: +�� <br /> O.0 486.0 4, TOTALSQUARE FOOTAGE: 4 (slopes,disturbance, i 0 r/ <br /> 2ND FLOOR: 3RD FLOOR: filling/access) f� <br /> 0.0 0.0 486.0 rr <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ -+ and available options. N A <br /> (Please round to nearest dollar) $ 1 2,000.00 ' <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes 'lo DJon't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes a. [Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes 1lo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes ao <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 Dlo [Don't know <br /> 7. Is this to correct a violation? [Yes [Vo <br /> 545112(4/08) ' PPLICATION MUST BE SIGNED <br /> (Continue on Back) - -+ -i <br />