Laserfiche WebLink
MPRLEMENT�to Web•APpa# <br /> ZONING PERMIT APPLICATION wuvacountyofdane.com . <br /> PROPERTY.OWNE INFQRMATIOIR 1��;. ffi gg nKir,_' �: '{.s -*,a CUSTOMER TO PROVIDE <br /> OWNER NAME I n g Zoning Status; CUP; � ��p� <br /> OWNER ADDRESS (Number,Street,City,Sta Zip) `� _ Deed Restriction; CSM 6'f0 <br /> 06 a.r K-�i/ c • icy k � S7" Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS - <br /> 8 - .(. I T8C er^rmnr aj I - re- �4 Site Plan drawn to scale <br /> AGENTTINFORM A_T_IONA _tr, 3 ' ;pia rCONTRACTOR D FO_ItiI ktib iMM: and includes dimensions 'j0 <br /> AGENT NAME CONTRACTOR NAME J <br /> it,v1 S•..= - . •, uding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS • o well/septic <br /> (City,State,Zip) (City,State,Zip) Setbacks 345-6 <br /> PHONE PHONE ,1 2 Site Plan approval from 4/ <br /> - applicable township. Ai 4-- <br /> E-MAILADDRESS E-MAILADDRESS <br /> • 4 Floor plans to scale <br /> `PROPERTY/LOCATION IMF0I)AA'tIOMa(httpUac_cessdane._ao,dane:vlij.us/)� * Elevation of property <br /> PARENT PARCEL NU BER CURR ZONI G: ACREAGE: <br /> ❑PARCEL /� (- (072_ frontage drawn to scale <br /> NUMBER V i q d +lU '!UI -Z SK" <br /> TOWNSHIP: SECTI A ' <br /> -I-L-Jr. u� grV e _ '/a: /V LE '/a : A/� iI. Driveway perm <br /> (state, county,Ctowl <br /> ADDRESS:„ 7 g U P(iv,v v.„,I(1 I r ` <br /> CSM: LOT SUBDIVISION BLOCK/LOT unitary pe :e� <br /> (public o— <br /> PROPOSED PROJECT_INFORMATION a �SIrP' RI: E-tY, <br /> PROJECT DESCRIPTION: ( / ,�� / `F <br /> eC`C- PC/' X �� - Ala; ° �1..tec ,„- ---,•. <br /> . RiThis project is a new building or,structure. :p �dPUste� i' <br /> This project is an addition/alteration to an existing building or structure. A- - <br /> SANITARY SERVICE• PERMIT NUMBER: X -ti�° -S -E <br /> . EWER . . EP-11C --f- e kV -4 <br /> W ,tea `— -, <br /> HEIGHT IN NUMBER OF STORIE • (Not including basement) � " -e-s``� *a <br /> (21 tt •- eYl ��F )_°°° 111 -_ <br /> _•k '`_ 110 a ° ttac` egr - <br /> AREA TO NEAREST SQUARE FOOT: ,,. .. y .' ”` - <br /> (Outside dimensions including unfinished area, attached garages an,. above grade decks •• porches) t,4-•:.t; - :- <br /> BASEMENT: 1ST FLOOR: e'� D_1•, r• pe- <br /> Z7 • ,, TOTAL SQUARE FOOTAGE j °°eS ° t� . :4,-;' '-r=-' ��/ <br /> 2ND FLOOR: 3RD FLOOR: <br /> / Zaii. <br /> � - 0, .-"mac ':�-�- <br /> S . k rra e. a -* e71 T/. <br /> ESTIMATED CONSTRUCTION COST: - o i e �• <br /> (Please round to nearest dollar) ♦ "� ♦ --► -•► --0, -�J� '°_ ` � <br /> ° Asa_ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? DYes ' KI, o.- DDon't-know <br /> 2. Is there a wetland or floodplain on or near the property? Dyes 51No .DDon't know . <br /> 3. Have you talked with the township about your project and are they in agreement'? ©Yes 2,o -. _ <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Eyes • ow . <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 c i, . - ❑Don't know <br /> 7. Is this to correct.a violation? -- DYes !No . <br /> . . ., <br /> • <br /> - -��� APPLICATION MUST BE SIGNED V . (Continue on Back) -0. -► -> <br /> 54$"1920/08) <br />