Laserfiche WebLink
SUPPLEMENT to Web-App# <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME ACM PROPERTIES LLC <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 7361 DARLIN DR.UNIT 1 DANE WI 53529 Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-8771 (608)712-1121 septicspecialsits @ tds.net <br /> Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> STEVE CROSBY 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 7361 DARLIN DR <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> DANE,WI,53529 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 712-1121 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> septicspecialists @tds.net ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ig <br /> ❑PARCEL 0808-043-5216-0 C2-0000-08077 5.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> SPRINGFIELD 4 14: SW 141 4: SW ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 7361 DARLIN DRIVE <br /> ig <br /> CSM: 11,016 LOT 2 SUBDIVISION BLOCK/LOT Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> NEW SIGN CONSTRUCTION LI Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: LI Rural Address <br /> FIEWER [EPTIC (new/existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 10.1 ❑ 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: ❑ ErosionControl permit <br /> TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 32.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) $ 200.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes '4No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? EYes EINo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes '4No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? EYes 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) EYes ONo ❑Don't know <br /> 7. Is this to correct a violation? EYes ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) — <br /> 545-112(4/08) <br />