Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Tim O'Brien Homes <br /> EC Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> Variance(# ) <br /> HOME PHONE ;CELL PHONE E-MAIL ADDRESS <br /> sfrohling @tobhomes.com '4 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Sue Frohling TIM OBRIEN HOMES 0 Site Pla Including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of wel tic <br /> 2601 Crossroads Dr.,Ste 140 2601 Crossroads Dr.,Ste 140 <br /> (city,State,Zip) <br /> (City,state,Zip) Setbacks <br /> Madison,WI 53718-7981 Madison,WI 53718-7981 <br /> PHONE PHONE ❑Site PIa royal from <br /> (608) 661-1100 (608) 661-1100 appli township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> sfrohling @tobhomes.com sfrohling @tobhomes.com io Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usl) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: leyatlon of property <br /> ElPARCEL 068-0910-294-4068-0 R-2 61aa I 0.34 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Windsor 29 1/: NW 1�41�4: SW ❑Drive permits <br /> \ /ADDRESS: (Stat Unty,town) <br /> V Lot 278, Wolf Hollow /' <br /> �v h eJ) EA Sanitary permits <br /> CSM: If D\1 278 SUBDIVISION BLOC OT <br /> 278 Wolf Hollow (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: {�� <br /> SINGLE FAMILY HOME \/s/ De.C [ling District <br /> This project is a new building or structure. ermitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: al Address <br /> EWER rEPTIC c '-0 g iikalw existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 28.0 2.0 VIte1-n /Floodplaira/ <br /> AREA TO NEAREST SQUARE FOOT: ShO, and (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> Ero Control permit <br /> u BASEMENT: 959.0 ST FLOOR: ^ n O 4, TOTAL SQUARE FOOTAGE: 4, (sbo+-s,disturbance, <br /> --F-VCJL / fill • access) <br /> 2ND FLOOR: 1 ,220.0,220.0 3RD FL R: v 11 ' <br /> J �1 (ft eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ --► -i ♦ ♦ an`d available options\, <br /> (Please round to nearest dollar) 240,000.00 <br /> L <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [-Yes ✓}Jo QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? JYes !o QDon'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 CNo <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) JQYes alo ['Don't know <br /> 7. Is this to correct a violation? QYes 151No <br /> AAE SIGNED <br /> (Continue PPLIC on TION BacMUST k) B-+SIGN-► - <br /> 545-112(4108) <br />