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ZONING PERMIT APPLICATION www.countyofdane.com� SUPPLEMENT to Web•App# <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Michael C. Wussow <br /> OWNER ADDRESS (Number.Street,City,State.Zip) <br /> Zon' g Status; CUP; <br /> 3110 Waucheeta Trail,Dunn,WI 53711 D d Restriction; CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) / <br /> (651)336-4600 (651)336-4600 mcwussow @gmail.com <br /> AGENT INFORMATION CONTRACTOR INFORMATION to Plan • awn to scale <br /> d <br /> AGENT NAME CONTRACTOR NAME udes dimensions <br /> AGENT ADDRESS o Site P .• '•cluding location <br /> CONTRACT:: ADDRESS of w- e. 'c <br /> (City.State,Zip) <br /> (City,State,Zip) acks <br /> PHONE PHONE O Site P approval from <br /> ap icable wnship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> F r plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> EPARENT PARCEL NUMBER: CURRENT ZONING: / ACREAGE: Vahan of property <br /> l PARCEL 028/0610-051-4173-0 R-2 /`" 2.37 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: !.I 1 61,.3 SECTION: <br /> TO6NR1OE 5 1/4: SW of the NE 1 1/4; rlVeway permits (° <br /> ADDRESS: (state, coun;, ow`■ 1 <br /> 3110 Waucheeta Trail, Dunn, WI 53711 <br /> CSM: LOT SUBDIVISION BLOCK/LOT 'r -' permits <br /> 13 +. 14_ ) publirivate) <br /> 'o. r i 0. <br /> PROPOSED PROJECT INFORMATION <br /> STAFF REVIEW <br /> PROJECT DESCRIPTION: • <br /> ■ _— 1 r,�„ <br /> Single Family Home renovation and -xpansion- •ease #p, ilb <br /> ase seeattached details. 4..zcni District <br /> ❑This project is a new building or structure. <br /> ermitted Use? <br /> 0 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: raI Ad. 5 <br /> EWER [EPTIC (new/ fisting <br /> HEIGHT IN FEET: NUMBER OF ST RI S: (Not including basement) <br /> 4.N Frv,.,t ) 2.0 ❑ Wetla d oodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shore a ttachment} <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) -0.�- <br /> BASEMENT 1ST FLOOR: ' ! , ostonControlperm 10 <br /> 1,874.0 6 619.0 4, TOTAL SQUARE FOOTAGE: 4, •= , . 1-lance, do <br /> 2ND FLOOR: 3RD FLOOR: filling/ cess) `J <br /> 2,424.3 0.0 10,917.3 0-e�f s <br /> view Location Survey ) <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) —' ♦ ♦ ♦ ♦ ♦ $ 1 95,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies ONo ODon't kno A <br /> 2. Is there a wetland or floodplain on or near the property? QYes JNo ODon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [ Yes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes ONo <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) E Yes ONo ODon't know <br /> 7. Is this to correct a violation? QYes NI No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) -+ <br />