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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 /> Travis Storch Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1938 Oakwood View Dr Verona Wi 53593 Varlanc .(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (323)309-3476 travisstorch @gmail.com •e Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Shane A.Larson Morton Buildings Ite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 411 E.Leffler St. 411 E.Leffler St <br /> (City,State,Zip) (City,State,Zip) ,ice �. �, ., [l-Whacks <br /> Dodgeville Wi Dodgeville Wi -�(_)JS ,.��,� <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 574-7662 (608) 935-2384 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS / <br /> shane.larson @mortonbuildings.com oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) n�evation of property <br /> PARENT PA^RC�ELNUMBER:/ g CURRENT ZONING: ACREAGE: L Si"`-' <br /> ElPARCEL <br /> NUMBER v p 04—a(o Y Ij Fs/d8 -- I 6, 3 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> G va. ' tt y1h: S E ❑Drivteu�� rmlts <br /> ADDRESS: f h5 A (sta , o nty,town) <br /> j Otik UJ o 1 <br /> O � �i� ►^i �Jf❑Sanl ermits <br /> CSM:} • LOT SUBDIVISION BLOCK/LOT (pub , •rivate) <br /> V <br /> PROPOSED PROJECT INFORMATION STAPP 11W <br /> PROJECT DESCRIPTION: <br /> Garage 30 xs Q GAning District <br /> . • IN This project is a new building or structure. nnitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER PTIC (newi •�. <br /> HEIGHT IN FEET: ) //////1`"�FF��"'''�.n NUMBER OF STORIES: (Not including basement) <br /> / •� I l,2 � 1.0 ❑ `. : d/F ...plain/ <br /> AREA TO NEAREST SQUARE FOOT: Shore (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ EfOSi• 0 •I permit <br /> BASEMENT: 1ST FLOOR: <br /> JS C) 0 4, TOTAL SQUARE FOOTAGE: 4, (slopes, • turbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/ s <br /> 1,500.0 ❑ Review o on Survey <br /> ESTIMATED CONSTRUCTION COST: and av options. <br /> (Please round to nearest dollar) "'� -"� .- ♦ $ 50,000.00 f <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ✓N° ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Yes al <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 ❑NO FdDon't know <br /> 7. Is this to correct a violation? [Yes ✓Jlo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) ♦ -0. -► <br />