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ZONING PERMIT APPLICATION www.countyofdane.coICY? ' 11,izazimatimlmaj <br /> m <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Clifford Miller ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 803 Whispering Oaks Road(Laura Kronser) <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAILADDRESS <br /> (608)835-9176 (608) 692-8878 kronser6 @charter.net 0 Site Plan diraw;eto scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includ imensions <br /> AGENT NAME CONTRACTOR NAME <br /> Zach Simpson Steve Mulcahy <br /> Site Plan.nc ing location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/se IC <br /> 6917 Donnybill Road 6788 Depot Street <br /> (City,State,Zip) (City,State,Zip) ❑Setks <br /> De Forest,VVI 53532 Windsor,WI 53589 ► <br /> PHONE PHONE 111 / f <br /> (608) 436-3333 (608) 575-7085 applcal(eTo 'n.hip. <br /> E-MAILADDRESS E-MAILADDRESS <br /> zachsimps @gmail.com Stevem069 @hotmail.com ts Floor play tale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dlane.wi.us/) ❑Elevati n roperty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑ <br /> NUMBER 071114298100 RH-2 j r 7.47 fronts raven to scale. <br /> TOWNSHIP: SECTION: <br /> • <br /> 018 14,711 1/4; NE %I A: Sw ❑ P <br /> Drivew <br /> ADDRESS: (State O n own) <br /> 2035 Uphoff Road, Cottage Grove, WI 53527 <br /> ❑Sani ermit <br /> CSM: 11 100 LOT 1 SUBDIVISION BLOCK/LOT (publi f�"`'r/I� � <br /> . <br /> PROPOSED PROJECT INFORMATION , <br /> PROJECT DESCRIPTION: a 3 <br /> Home remodel with garage and porch addition. Remodel will include interior and exterior improvements 0 Zo ing Distr <br /> . ❑ 0 This project is a new building or structure. Perm <br /> 0 This project is an addition/alteration to an existing building or structure. - <br /> SANITARY SERVICE: PERMIT NUMBER: © Rural Add ess& <br /> EWER [EPTIC (flew/ems i ') <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 10.0 1.o CI-W:41:4: ,.. .,ialn/ <br /> Sho i attachment), <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1L00 <br /> Erosion, =r 1 al�errnit <br /> 0.0 <br /> 4, TOTAL SQUARE FOOTAGE: j -Sl®+ . , +anCe, <br /> filling s} <br /> 2ND FLOOR: 3RD FLOOR: 0.0 t5i9 _ar7-6610- 0 R ; fit,, Survey <br /> ESTIMATED CONSTRUCTION COST: -+ "+ -+ -+ -+ ♦ an• t tioins a <br /> ti (Please round to nearest dollar) $ 150,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ISINo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ['Yes ✓ENo ['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 is <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 cg No ['Don't know <br /> 7. Is this to correct a violation? ❑Yes Is <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —s —4 —► <br /> 545-112(4/08) <br />