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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Bill Mansfield <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1509 Oak Opening Dr Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)577-5056 bill @ontrac kcom.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> —tp,Av,yS� Cleary Building Corp ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> _ 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Verona,WI <br /> PHONE PHONE ❑Site Plan approval from <br /> --') (608) 379-0132 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> -4 tleeser©dearybuilding.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑PARCEL 052/0510-011-9541-0 RH-2 6.15 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Rutland 1 1/4: SW %1/4: NE ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 1509 Oak Opening Dr <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 9,683 4 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 24x45 storage shed with 8'x45 porch ❑ Zoning District <br /> . l51 This project is a new building or structure. ❑ Permitted Use? <br /> OThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER r)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 18.0 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: 1—, ErosionControl permit <br /> ,` TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 1,440.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available O dons. <br /> (Please round to nearest dollar) ." - —' '-' ♦ -+ $ 25,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ✓❑4o ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes Ro ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ao <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) DYes Epo DDon't know <br /> 7. Is this to correct a violation? Dies E:li10 <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) ■ —► -♦ <br />