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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App I <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME I� <br /> Ryan Hanna ►v4 Zoning Status;CUP; /•` <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 761 Maple Drive,Mt.Horeb,WI 53572 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> jeremyicraftsmanbuilding.com Site Plan drawn to scale <br /> AGENT INFORMATION 1 CONTRACTOR INFORMATION and includes dimensions 14 <br /> AGENT NAME CONTRACTOR NAME <br /> Jeremy Strobel Craftsman Construction Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 600 Camp Street 600 Camp Street /r <br /> (City,State,Zip) (City,State,Zip) Setbacks /L 2/2--)/°/-- <br /> Baraboo,WI 53913 Barbaboo,WI 53913 <br /> PHONE PHONE OSite Plan approval from , <br /> (608) 212-4285 (608) 356-2332 applicabletownship. N Ft1 <br /> l <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> jeremy @craftsmanbuiiding.com 0 Floor plans to scale <br /> V PROPERTYILOCATION INFORMATION (http:tlaccessdane.co.dane.wt.us/) Elevation of property y <br /> PARENT PARCEL NUMBER: CURRENT ZONING. ACREAGE: p p e <br /> 0 PARCEL 054/0607-234-9700-0 A - I 1.83 frQfl to Scale. <br /> NUMBER <br /> TOWNSHIP. SECTION: <br /> Springdale 23 +%: SE Wj4+/4: SE '!a Drivewa rmits <br /> ADDRESS: Hwy J Z : 0 E C_�� (state, count town) <br /> CSM: LOT SUBDIVISION BLOCKC/LOT <br /> t ant ary evill r <br /> 1 10,595 1 nla ------ (public,,•rivat <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: i" j{ <br /> New Single Family Residential Home Nv1A0 y cP✓it- l0C f- / S C- /0" Zoning District t'f't ( <br /> . 12 This project is a new building or structure.aVvyje. Use? C- <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> 1', f�uFatAddress <br /> SANITARY SE' E: PERMIT NUMBER: <br /> -.�,,.. , 13,201,600,028 new xisting) <br /> HEIGHT IN FEE•. NUMBER OF STORIES. (Not including basement) , <br /> 28.0 1.0 Wetland/Floodplain/ 4 / <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) .&� ErosionCOntrol permit <br /> BASEMENT: n 52� 0 1ST FLOOR: 090.0 <br /> G 4. TOTAL SQUARE FOOTAGE: j, (slopes,disturbance, <br /> ' 61e filling/access) AY( �I <br /> 2ND FLOOR: 3RD FLOOR: <br /> 4 Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: 460,000.00 and available options. 4/ <br /> (Please round to nearest dollar) '♦ -► -* ♦ —* -÷ � <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake'?........... [ Yes to ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes ao QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? [ Yes DNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ElYes alo <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 'o fon't know <br /> 7. Is this to correct a violation? Eyes f[ Jo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —0- —► —► <br /> 545-112(4p$) <br />