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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Mark Codde/Janna Rose Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed 6110 Knollwood Dr,Oregon,WI 53575 Variance Restriction;CSM <br /> Vnce(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)835-2791 (608)576-3234 codde.sparty @gmail.com Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION a d includes dimensions <br /> AGENT NAME (� CONTRACTOR NAME <br /> Temple Builders,LLC ht. - e - C^ Temple Builders,LLC Site Plan including location <br /> AGENT ADDRESS r \ . I S CONTRACTOR ADDRESS of well/septic <br /> 2501 W Beltline Hwy,Suite 113 Tb• t 2501 W Beltline Hwy, Suite 113 <br /> (City,State,Zip) (City,State,Zip) I I S tbacks <br /> Madison,WI 53713 Madison,WI 53713 <br /> PHONE PHONE Site Plan approval from <br /> (608) 729-3990 (608) 729-3990 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jsimon @templebuilds.com jsimon @templebuilds.com FIo r plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wl.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: (`� <br /> ❑PARCEL 062/0608-353-8640-0 R ik .4-11. frontage drawn to scale. <br /> NUMBER t' <br /> TOWNSHIP: SECTION: <br /> Verona 35 +/4: SW %/4+/4: NW Driveway permits <br /> ADDRESS (state,county,town) <br /> Lot 4 Black Cherry Court <br /> CSM. 14 036 LOT 4 SUBDIVISION BLOCK/LOT S(public, permits <br /> private) <br /> PROPOSED PROJECT INFORMATION . ,STAFF REVIEW <br /> PROJECT DESCRIPTION: i �Y� \�f, <br /> New residential home '1\J / I' – t- C� y L-- /'1- Aj ( 'CJ: oning District <br /> . NI This project is a new building or structure. �d, X � ' C c 1\/S�" /7 <br /> p 1 g ;'Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. ! <br /> SANITARY SERVICE: PERMIT NUMBER: ural Address <br /> EWER rEPTIC 13,201,600,006 (\(new/existing) <br /> HEIGHT IN FEET: + t NUMBER OF STORIES: (Not including basement) - <br /> 21 -0 t+,), 1.0 ❑ Wetland/Floodplain/ <br /> 6horelan5I(attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> o• ' - •' ensi•• • -- -'- • d-aree;attached..gaca and above grade decks or porches) / <br /> BASEMFNT: 1ST FLOOR: y EroslonCOntrol permit <br /> a •5 ' q (), n�n a[A 5D,..,0 Sr�t(O.��, f� 1 OTAL SQUARE FOOTAGE: 4 (slopes,disturbance, <br /> l✓J 1 /� % ` vrNr{u� filling/access) <br /> ••FLOOR: 3RD FLOOR: <br /> Cpl Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: 0" and available options. <br /> (Please round to nearest dollar) ♦ -i Q{('(�t 000.— ;,t._} <br /> 'I <br /> 1. The property is within 300 feet�'F a stream or 1000 feet from a pond'o7 ,ake? Wes to ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? 01'e EDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? Oes I=INo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Des Dfo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank' one) <br /> 6. Is a location survey required? (see reverse) [Yes N Don't know <br /> 7. Is this to correct a violation? Wes Ir Vo <br /> [4 ,, , <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ♦ -+ <br /> 54112(4/0 <br /> : f CO ''OR g . --7,---) (.:,76. , . , <br /> si)ti_c s 1 4-er <br /> ,_. . --C --V ' <br />