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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App #1 <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Brabender Century Farm, LLC <br /> OWNER ADDRESS (Number,Street,City,State,Zip) ❑Zoning Status;CUP; <br /> 6963 County Road K, Middleton, WI 53562 Deed Restriction; CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (608)831-7373 (608)225-1987 drt57@aol.com <br /> 0 Site Plan drawn to scale <br /> AGENT INFORMATION <br /> CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Debra Tracy W4 ,e L,'&-d r John Kempf Construction, LLC <br /> ❑ <br /> AGENT ADDRESS Site Plan including location <br /> 6963 County Road K (,4R( C-t' ik k CONTRACTOR ADDRESS of well/septic <br /> 5 S4068 Wood Road <br /> (City,State,Zip) (City,State,Zip) Q Setbacks <br /> Middleton,WI 53562 Wonewoc,WI 53968 <br /> PHONE 5 17- 4 3oO PHONE Q Site Plan approval from <br /> (kl 831-7373 (608) 495-0012 applicable township. <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> drt57@aol.com N/A(Amish) 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: Q Elevation of property <br /> pg PARCEL 0808-274-8580-1 <br /> NUMBER Al 118.80 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Springfield 27 %: NW wh: SE 0 Driveway permits <br /> ADDRESS: 6991 County Road K, Middleton, WI 53562 (state,county,town) <br /> csM_ 2,066 LOT SUBDMSION BLOCK/LOT ❑Sanitary permits <br /> Na Na (public,private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: STAFF REVIEW <br /> Deck attched to existing barn ❑ Zoning District <br /> ❑This project is a new building or structure. <br /> ❑ Permitted Use? <br /> 12 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER:5 CI Rural Address <br /> HEWER PEPTIC ,616 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 4.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ECOSIOnContl of permit <br /> 4 TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: (,, filling/access) <br /> ' S ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ -�► -► ♦ -► - and available options. <br /> (Please round to nearest dollar) i $ 9 000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes t io ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes BOW QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? QYes ICENo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes 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) QYes ✓❑No [Don't know <br /> 7. Is this to correct a violation? Elves ON <br /> APPLICATION MUST BE SIGNED <br /> 545-112 Wosi (Continue on Back) -• -40 -+ <br />