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":SUPPLEMENT to Webatil#_ <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY;'OWNER INFORMATION , . -; a .,5::, Fi,.:.- ., r•s .,;:,. >>- F '.. CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> k_2Vi1i Ur ,/Io, oningStatus; CUP; <br /> OWN ADDRESS (Number,Street,Ci e,zip) Deed Restriction; CSM <br /> c-s `JS / S I Variance(# ) <br /> HOME PHONE CELL PHONE E-MAILADDRESS - <br /> a3S S Lii,erre7lan drawn to scale <br /> AGENT IINFOROATIOhI ...': ,,:> - r;.3... ,CONTRACTORt INFORMATION f ,-my;,.f ": and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> S. Plan Including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS • of well/septic <br /> (City,State,Zip (City,State,Z' S acks <br /> PHONE PHONE ❑ Site Pla oval from <br /> appl. ownship. <br /> E-MAILADDRESS -- E-MAILADDRE <br /> FI r plans to scale <br /> PROPERTY/L)CATION INFOR MATION (httpe l%accessdane.co,dane.wi.us/)., <br /> PARENT PARCEL NUMBER: .0 CURRENTZONING; ACREAGE: Ele ation of property <br /> El UMB <br /> NER -C f e q j Os 05 I2- - Li c , S ntage drawn to scale. <br /> TOWNS SECTION: <br /> '/4: '/4'/a: ❑ Drive ay --rmits <br /> Vn n✓ (state unty, town) <br /> ADDRE �� � s ] <br /> CSM: V (/ SUBDIVISION BLOCK/LOT ❑Sanit. p= te) <br /> � (pub'-, �rivate) <br /> PROPOSED PROJECT INFORMATION.'.' _ $ P flii 11EW.� gkG <br /> PROJECT DESCRIPTION: t '`hl.i <br /> �O.✓� S>tVl24..�1a � � 404111 I5114k <br /> . his project is a new building o structure. ant I- <br /> mltted Use 4 -�-. : <br /> ❑This project is an addition/alteration to an existing building or structure. i. ``• , 'y -, �_ <br /> SANITARY SERVICE: PERMIT NUM,.BER: ©_ Rur• -a)Address yr <br /> DEWER TIC / "' µk t,lit <br /> HEIGHT IN FEET NUMBER OF STO (Not including basement) 3 4' • r x� �£-* <br /> I � /� 12,+etlali l- •m .ta(n <br /> ' �/ 6 -£ Sf�o�e't i 4 attach.me )' <br /> AREA TO NEAREST SQUARE FOOT . , y ` `. <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) `' i " - _. <br /> m, <br /> 1 1 S 4 TOTAL SQUARE FOOTAGE: .1. `ts1gp ti tssturbatice, <br /> 2ND FLOOR: 3RD FLOOR: ` 4 E'n � - <br /> ESTIMATED CONSTRUCTION COST: d� C and_a1r�ailittie efions, <br /> (Please round to nearest dollar) ♦ "♦ --► --► --> $ rn _ __ .€ ' <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes ❑No ❑Don't.know <br /> 2. Is there a wetland or floodplain on or near the property? Elves ❑No .❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? [yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dies ONO . <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 ❑No ['Don't know <br /> 7. Is this to correct a violation? Oyes ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —* —► —I► <br /> 545-112{4/0B) . <br />