Laserfiche WebLink
,....4-.--, <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION C STOMER TO PROVIDE <br /> OWNER NAME <br /> Jose Rojo Zoning Status;CUP; <br /> OWNER ADDRESS (Number.Street City.State.Zip) Deed Restriction; CSM <br /> 5556 Surry Lane,Waunakee,WI 53597 Variance(# ) <br /> HOME PHONE 1 CELL PHONE E-MAIL ADDRESS <br /> I (608)448-5077 solomio0415 @gmail.com ite Plan drawn to scale <br /> AGENT INFORMATION 1 CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dave Budden Meigs Inc. ❑ to Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS f well/septic <br /> 1527 HWY 14 P.O.Box 412 1527 Hwy 14 P.O.Box 412 <br /> (City,State.Zip) (City,State,Zip) ❑Setbacks <br /> Black Earth,WI 53515 Black Earth,WI 53515 <br /> PHONE PHONE ❑S. Plan proval from <br /> (608) 767-2729 (608) 767-2729 pplica a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com dave @meigsbuilds.com loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn levation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p y <br /> ❑PARCEL 004/0807-124-8000-5 A-1(EX) 20.00 frontage draw to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Berry 12 '/a: '/a%a: ,ALE--.. V Drivew permits <br /> ADDRESS: (St ,count Own) <br /> 5991 Whippoorwill Cross Plains, WI 53528 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanita permits <br /> pub. ,private) <br /> PROPOSED PROJECT INFORMATION OF STAFF REVIEW <br /> PROJECT DESCRIPTION: � X /) j <br /> Run-In Shed#3 ! oning District <br /> . al This project is a new building or structure. 2 Permitted ? <br /> ❑This project is an addition/ teration to an existing building o st uc e. <br /> SANITARY SERVICE: PERMIT NUMBER: LI Rural dres <br /> FTEWER EPTIC (new/e 'stin <br /> HEIGHT IN FEET: NUMBER OF STORIES: (N t including basement) <br /> 8.9 1.0 ❑ Wetlan oodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shor nd (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) r-1 ErOSIOr1COntr ermit <br /> BASEMENT 1ST FLOOR: 300.0 4, TOTAL SQUARE FOOTAGE: 4, (slopes,di rbance, <br /> filling/a ess) r\ <br /> 2ND FLOOR: 3RD FLOOR: <br /> ' . © ® ❑ Review Location Survey O <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> ♦ ♦ <br /> (Please round to nearest dollar) $ 4,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes a° ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes Oslo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? OYes ❑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) Ekes No ❑Don't know <br /> 7. Is this to correct a violation? ['Yes ✓❑fNo <br /> sa545-112(aroe) 7,y e APPLICATION MUST BE SIGNED <br /> (Continue on Back) — -o -0 <br />