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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Phillip L. Purdy ,4 <br /> ,.ox <br /> Deed ADDRESS (Number,Street,City,State,Zip) Zoning Status; CUP; <br /> 1796 Strawberry Road, Deerfield WI 53531 Deed Restriction; CSM <br /> Imo- i <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> uwbud @aol.com `� Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION :n• . .T.•.-•-nsio <br /> AGENT NAME CONTRACTOR NAME <br /> " e - an including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) KSetbacks G ,0 /o f o <br /> PHONE PHONE 0 Site Plan approval from <br /> applicable township. Ar <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Fd Floor plans to scale / or <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: Q Elevation of property <br /> ❑PARCEL 0711-122-9001-7 A-1 EX 38.90 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Cottage Grove 12 14; nw wh: nw IN Driveway permi <br /> ADDRESS: (state,county, / <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary •.v---• <br /> (publi,,private <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> 60'x PROJECT DESCRIPTION: <br /> . A __1 � <br /> 60'x 50'x 21'machine shed Zoning District /[Vj <br /> . Igi This project is a new building or structure. o►A1 )Permitted Use? /144 v �?, <br /> :This project is an addition/alteration to an existing building or structure. i <br /> SANITARY SERVICE: PERMIT NUMBER: Rural A•"' `•`+d'/� <br /> EWER [EPTIC new/= + <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 21.0 1.0 - -•® •odplain/ <br /> - - - k,c ment) (Cpr—s-e-y <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) i <br /> BASEMENT: 1ST FLOOR: 0'� ErOSionControl permit en <br /> 3,000.0 + TOTAL SQUARE FOOTAGE: + (Slopes,disturbance, V D j <br /> 2ND FLOOR: 3RD FLOOR: / <br /> 3,000.0 � �/p (' <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available Options. <br /> (Please round to nearest dollar) ♦ -' ♦ ♦ ♦ '— $ 18,000.00 <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? Dies Jio :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 ✓ 'Jo <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 ODon't know <br /> 7. Is this to correct a violation? :Yes ✓jlo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► ■ —► <br /> 545-112(4/08) <br />