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LW- <br /> ZONING PERMIT APPLICATION www.countyofdane. om SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Justin Vondra / Vondra Living Trust ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 4444 Oak Hill Rd Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL A[DRESS <br /> (608)757-4205 justin @ddclean.com ❑Site Plan atravflo scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includ dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cleary Building Corp ❑Site Plat. location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/s tic <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) ❑Setb ks <br /> Verona,WI <br /> PHONE PHONE ❑Site P p al from <br /> (608) 379-0132 appli town hip. <br /> E-MAIL ADDRESS <br /> E-MAIL <br /> tleeser @clearybuilding.com Floor planate <br /> PROPERTY/LOCATION INFORMATION (http://acc:essdan.e.co.dane.wi.usn ❑Elevation pr erty <br /> PARENT PARCEL NUMBER: CURREN ZONING: ACREAGE: <br /> ❑PARCEL 052/0510-083 9310 7 RH-2 4.35 frontage dr n to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town Of Rutland 8 <br /> 1/4: SW '/a'/a: SW ❑Driv r ay • <br /> ADDRESS: <br /> (star, •-u y, own) <br /> 4444 Oak Hill Rd Oregon, WI <br /> *itare: <br /> CSM: 6,412 LOT 1 SUBDIVISION BLOCK/LOT El LOT ni • •Ainf f. <br /> d ^ rx <br /> PROPOSED PROJECT INFORMATION a. <br /> PROJECT DESCRIPTION: <br /> Vondra Accessory Building r � ro-p�' <br /> i�This project is a new building or structure. 44 <br /> ['This project is an addition/alteration to an existing building or structure. <:..: <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> ;■.EW .r c,• r * ' <br /> ER I��:PTIC �`s„ , r ' ' sNUMBER OF O : (Not including - : ,,HEIGH IN FEET: 26.0 1.0 basement) <br /> AREA TO NEAREST SQUARE FOOT: ' '4 <br /> (Outside i ensions including unfinished area, attached garages and above grade decks or porches) °" ,1 7,, - t„t. <br /> BASEMENT 1ST FLOOR- 1__ -t • -VV, <br /> 4, TOTAL SQUARE FOOTAGE: 4, ,� <br /> 2ND FLOOR 3RD FLOOR: '2 : `n. V' <br /> ESTIMATED CONSTRUCTION COST: <br /> (Please round to nearest dollar) "� "� "� $ 1 50,000.00 -; _ -; _ ` <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes INo ❑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? ❑Yes 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) ❑✓Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ONo <br /> IAUST 13.+E SIGNED <br /> (Continue APPL C on TION Back)M <br /> 545-112 r4/08t <br />