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r DANE COUNTY - ZONING PERMIT APPLICATION - `4 � <br /> ROAD - <br /> J SEC 34 <br /> • <br /> I <br /> LOP BLK SUBDIVISION NAME OR C. S. M. NUMBER <br /> C.U.P. # <br /> TYPE OF IMPROVEMENT -PROPOSED USE <br /> 1 ` - <br /> [ ] New building 1 ) 001 One family bldg 1 ] 013 Sery sta/garage <br /> [ Addition C ] 002 Two family bldg [ ] 014 Hospitals/institutions <br /> [ ] Alteration [ ] 003 Three/four family bldg [ ] 015 Office/professional <br /> C 3 Repair/replacement C 3 004 Five/more family bldg C ) 016 Public works/utility <br /> C ] Moving/relocation C ] 006 Transient hotel/motel - C ) 017 Schools/educational ' I <br /> TYPE OF FRAME [ ) 008 Amusement/recreational C )_018 Stores/mercantile <br /> t C ] 009 Churches/religious CI A-019 019 Other non-residential <br /> I 3 Wood frame C ] 010 Industrial bldg [ ) 020 Tanks/towers <br /> k [Masonry (wall bearing) C ) 011 Parking garage C ] 021 Add/alt residential <br /> [ ] Structural steel C ] 012 Residential garage [ ] 022 Add/alt non-residential <br /> C ) Reinforced concrete PROPOSED USE (If non-residential, describe in detail) <br /> C ] Other <br /> A pp /✓ y 29 06- k t-�4/ <br /> SEWAGE DISPOSAL <br /> f <br /> [ ] Public <br />, [1 Private _ <br />+ . CU'Li/4/i E- / S/1/�te <br /> it Permit # /v k - <br /> DIMENSIONS OWNER <br /> .3 -s3 = <br /> Long 3 1�Wide Su // P/` /9 //8/ <br /> Stories 1 Feet <br /> fv1 • ` _ <br /> Total floor area t <br /> `r /r 4.-,.e / , <br /> Total lot area CONTRACTOR _ c." / -t • - a ,/,',/ <br /> l'-'. <br /> PARKING SPACES / r <br />� <br /> ` Required The undersigned and the owner of this building agree to -conform to <br /> Furnished all/applicable; ordinances of Dane County. <br /> ;Y <br /> SHORELAND/FLOOD PLAIN t' j �;' • ./. ,. - <br /> Permit # Signature of owner: or hie a Kt! J ',r Date <br /> ., i, , _ - <br /> VARIANCE INSPECTION RECORD <br /> Permit # Front yard Right yard, Left yard Rear yard <br /> DWELLING UNITS (003-004) Date By Certificate issued By <br /> 1 br - . <br /> Notation <br /> 2 br --•� � 3br . <br /> Total - _ - . , - - <br /> , �{ <br /> PERMIT # ? � - FEE � .. VOUCHER OR RECEIPT" } IC 7 2. '- DATE /o-.51�; f <br /> - / ,,t� G <br /> l' ' COST OF BUILDING . 4 ;,7O by 1" 11S".f ,G7 <br /> � � _ Issued �• � ...G� '• <br />