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A <br /> • <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Michael and Lynn Duesing ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 4208 Morris Park Road, McFarland,WI 53558 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)838-9340 (608) 577-5938 mduesing @tds.net 0 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Homestead Builders Q Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 4606 Pflaum Road <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Madison,WI 53718 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 222-2122 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> russdonh @aol.com 0 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 046/0611-272-8410-0 8.32 frontage drawn to scale. <br /> NUMBER IZt-I-3 eics,70 <br /> TOWNSHIP: SECTION: <br /> Pleasant Springs ` 27__ �4. NE 1/1/;__ NW 0 Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2057 Spring Road Sanitary <br /> CSM: 12 213 LOT 4 SUBDIVISION BLOCK/LOT permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Single Family Residence 0 Zoning District <br /> . 0 This project is a new building or structure. 0 Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: LI Rural Address <br /> EWER rtriEPTIC 520418 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 26 2.0 © Wetland/ loodplainl <br /> AREA TO NEAREST SQUARE FOOT: SFiOrelenc! (atlaaterit) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: CI ErosionCO trot permit <br /> 2,745.0 2,136.0 4, TOTAL SQUARE FOOTAGE: 4, (slopes,diisturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/weeds) <br /> 790.0 2,926.0 ❑ Review Location Survey. <br /> ESTIMATED CONSTRUCTION COST: and'available options. <br /> (Please round to nearest dollar) —' ♦ ♦ —► ♦ ♦ $ 425,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes cg No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Lives ✓❑No ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes EgNo <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? Elves 1310 <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► ■ —► <br /> 545-112(8/09) <br /> l'rtic 33 ••�6 71 <br />