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gicak 6-, 5i-t),Ne j 4, <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web•App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Dave and Candace May <br /> 4 Zoning Status. P; <br /> OWNER ADDRESS (Number.Street,City,State,Zip) Deed Rest ion; CSM <br /> 1200 Spahn Dr.,Waunakee WI,53597 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6684 (608)576-4728 4 cmay @tricorinsuance.com 0 Site Plan to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includ s dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Scott Moran Creative Landscapes Inc. <br /> Q Site Plan inc ing location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/s c <br /> 662 US Hwy 12 and 18 662 US Hwy 12 and 18 <br /> (City,State,Zip) (City,State,Zip) INI Settiks <br /> Cambridge WI 53523 Cambridge WI,53538 <br /> PHONE PHONE 4 Site PI a ,i•v. from <br /> (608) 423-4241 (608) 423-4241 applic 1 I, .hip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> scott@theloghomeguy.com scott@theloghomeguy.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usr7 Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: NI <br /> ❑PARCEL 004/0807-223-8180-0 RH-4 • 1 32.29 frontage drawn to scale. <br /> NUMBER 11 <br /> TOWNSHIP: SECTION: <br /> Town of Berry 22 <br /> 1/4: '/a'/a: 4 Drivew per its <br /> ADDRESS: (state,c` ' r `town) <br /> Pending co 1 0i' 0 It cr <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sa t- '' r i <br /> 11,031 1 (pu= ',, iti=' <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Mixed material single family home. ❑ Zonln Dis ' t <br /> . riThis project is a new building or structure. ❑ Pe • ed`Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ -ural Address <br /> EWER [EPTIC 13,201,500,362 <br /> iip. texisting) <br /> HEIGHT IN FEET NUMBER OF STORIES (Not including basement) <br /> 31.0 2.0 ❑ Wetland/Floodplain/ <br /> Shorela <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions i ling ng unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 7.1 1ST FLOOR: p '❑ ErosionControl permit <br /> ! 2,982.0 + TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, K <br /> filling/access) <br /> 2ND FLOOR: 1,160.0 3RD FLOOR: , 4 9,418.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) —I. ♦ —11. —. ♦ —1. $ 950,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes '4No 4Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Dies JNo 4Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Ol'es ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes rdNo <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 rNo ❑Don't know <br /> 7. Is this to correct a violation? Dies IS No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) -• -+ - <br />