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DCPZP-2016-00313
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DCPZP-2016-00313
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6/8/2016 2:17:42 PM
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6/8/2016 9:31:20 AM
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Zoning Permits
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DCPZP-2016-00313
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. <br /> • <br /> DANE COUNTY ZONING DIVISION <br /> CITY COUNTY BUILDING, RM 116 • <br /> 210 MARTIN LUTHER aNG, JR. BLVD. • �MADISON,WISCONSIN 53703-3342 <br /> - <br /> PHONE 266-4266 FAX 267-1540 T+ - <br /> www.cou ntyofd a n e.cornIzo ni n q <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> 1. LANDOWNER: • Gl(2_4I A-N 2�/-� AGENT: �4 A- if <br /> ADDRESS: ?5- S Spiel yaGI`LJ W� ADDRESS: <br /> (r ctZoay\a. n'te ws 5 (a'D <br /> PHONE: ICI D S °' v�O !"i l 33k PHONE: <br /> EMAIL: AN.NZ Q,V L k &A hanVs,(e mm EMAIL: • <br /> 2. TYPE OF PROJECT: <br /> ESTIMATED COST OF CONSTRUCTION: $ r h <br /> ( ()1 /� <br /> ( 00 (Structure plus mechanicals) <br /> 3. • ADDRESS OF PROJECT, IF KNOWN: f i_e.\ vailes ._• <br /> 4. LOCATION OF PROJECT: �• �., <br /> N� !� Z '`• <br /> TOWNS/•lIP,SECTION,1/41/4 `"l � �[{ � I Q <br /> TAX PARCEL NUMBER <br /> SUBDIVISION OR CSM#(Certified Survey Map),IF ANY: <br /> LOT NUMBER,IF ANY: <br /> 6. ZONING DISTRICT: CA r <br /> 7. SITE PLAN: `A site plan must be drawn to scale showing the lot lines and lot dimensions, the/ocatior, <br /> and size of all existing and proposed buildings or additions and their distances from 'C • 'i ' <br /> lot lines. If the lot is not served by public sewer, the location and size of the on site . <br /> septic system and the location of the well shall be shown on the plan. <br /> Example of a Site Plan on reverse. • , • .• t <br /> I. • • .. <br /> 8 FLOOR PLANS AND ELEVATION VIEWS{front, sides, rear): A copy wi/f be'kept in Zoning biv, ion files <br /> Examples of Floor Plans and Elevations attached. <br /> 9. PUBLIC SEWER OR PRIVATE SEPTIC SYSTEM? '-V --- <br /> STATE SANITARY PERMIT NEEDED? N IF YES, PERMIT# 13-OYJ I tv 0013O <br /> APPROVAL FOR ADDING BEDROOM OR > 25%AREA NEEDED? Y/�1 IF YES. PROVIDED? Y/N <br /> 10. DRIVEWAY(or Culvert or Access)PERMIT NEEDED? Y()IF YES. PROVIDED? Y <br /> Many Towns require a Driveway Permit;County Highway Department or WDOT permits may be required for <br /> driveways with access too County,State or US Highway <br /> 11. SHORELAND? Y/IV) FLOODPLAIN? Y(N TL <br /> WEANDS Y/ <br /> 12. TOTAL AREA OF LAND DISTURBANCE (Square feet) - <br />
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