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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 /> Viking Village Campgrounds & Resort, Inc. n Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street.City.State,Zip) <br /> Deed Restriction; CSM <br /> 1648 County Road N. Stoughton,WI53589 <br /> Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)873-6601 sherryleesweeney @gmail.com ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Ramaker&Associates. Inc. Nelson Building Services. LLC n Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 855 Community Drive 648 Taylor Lane <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Sauk City,WI 53583 Stoughton,WI 53589 <br /> PHONE PHONE n Site Plan approval from <br /> (608) 643-4100 (608) 220-9113 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dmatzke @ramaker.corn nelsonbuilding @gmail.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 /> ❑PARNUMBER CEL 046/0611-334-8221-9 RE-1 DEPREZ-0000-02186 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Pleasant Springs 33,611 <br /> 1/4: SE ',41/4. n Driveway permits <br /> ADDRESS: (state, county,town) <br /> 1648 County Road N, Stoughton, WI 53589 <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION• <br /> New swimming pool to replace existing - ❑ Zoning District <br /> . <br /> This project is a new building or structure. <br /> ❑ Permitted Use? <br /> rThis 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 /> 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (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: ❑ ErosionControl permit <br /> j TOTAL SQUARE FOOTAGE: 1 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> isac <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: $ <! . and available options. <br /> (Please round to nearest dollar) -► ♦ -40. ♦ —pi. ♦ U� C D 0 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? nYes nNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes 17-No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? nYes No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? nYes nNo <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 nNo ❑Don't know <br /> 7. Is this to correct a violation? nYes 4No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ <br /> 545-112(4/08) <br />