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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 /> Jerry & Judith Hunter Zonin Statu • UP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed e • ion; CSM <br /> 811 State Road 138,Stoughton,WI 53589 <br /> Varian # ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)541-8930 (540)449-9134 )ude.tnsnter2@gmail.com ' fl Site Plan awn scale ' <br /> AGENT INFORMATION CONTRACTOR INFORMATION and indud s imensions <br /> AGENT NAME CONTRACTOR NAME <br /> n/a n/a [J Site Plan in uding location <br /> 'AGENT ADDRESS CONTRACTOR ADDRESS of ' <br /> (City,State,Zip) (City,State,Zip) l_]Set <br /> PHONE PHONE 0 Site P . •4, - from <br /> appli•_! - • ship. <br /> 'E-MAfLADDRESS E-MAIL ADDRESS <br /> 0 Floor plarcale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of petty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> , ,0PARCEL 026/0511-1-84-9850-0 , 5S3 frontag awn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> ' Town of Dunkirk 18 %: SE W/4: SE . 0 Drive S . <br /> Road Q �+ A (stat ,coun , wn) <br /> ADDRESS: Q 11 State Road 138, Stoughton, �r 1 53589 • <br /> CSM: �J LOT SUBDIVISION BLOCK/LOT `S I ?. W It( or <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECtDSCR115T16 : <br /> (j pet, loo r W o r if c 4 U,° ❑ Zoning d <br /> . This project is a new building or structure. <br /> ❑ Permitt Use? <br /> This project is an addition/alteration to an existing building or structure. , <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Ad•�.� <br /> ' ntwER EPTIC (new/3 W..) . <br /> HEIGHT IN FEET: (NUMBER OF STORIES: (Not including basement) n <br /> I Z 1.0 irl <br /> Shot a chment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> ' (Outside dimensions including unfinished area,attached garages and above grade decks or porches)' ' <br /> BASEMENT 1ST FLOOR: n / CI.0 <br /> •ntrol permit <br /> a,tit1V.V . 4, TOTAL SQUARE FOOTAGE: 3 (SI••_ till: ' •ante, <br /> fillin�- 1 of' -) <br /> 2ND FLOOR: 3RD FLOOR: 'nVon W.n <br /> V <br /> T ❑ Revi Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ and r 'a options. <br /> ' (Please round to nearest dollar) $ 5,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? 01'es EiNo ['Don't know <br /> 2. is there a wetland or floodplain on or near the property? [ es y o °Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [ es to <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Efres 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) Dies 19(o QDon't know <br /> 7. Is this to correct a violation? laes 016 <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -► -1 <br /> 545-112(4/08) <br />