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SUPPLEMENT to Wob-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Randy Alexander <br /> 0 Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 2797 Lalor Road,Oregon,WI 53575 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)852-5615 rpa @torquecompanies.com <br /> n Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> JSD Professional Services, Inc. ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 161 Horizon Drive Suite 101 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Verona,WI 53593 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 848-5060 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> kevin.yeska @jsdinc.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accsssdans.co.dana.wl.us/) El Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ElPARCEL 0610-072-9000-3 A-1 76.66 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Town of Dunn 7 1/4: SW 1/41A: NW ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2797 Lalor Road, Oregon, WI 53575 <br /> CSM: LOT SUBDIVISION BLOCK/LOT El(public, permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Construct a 13,173 sq.ft.enclosed horse arena on cropland. ❑ Zoning District <br /> . ri This project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> [)EWER PEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 24.0 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: 13,173.0 , TOTAL SQUARE FOOTAGE: (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 13,173.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ ♦ -' ♦ ♦ $ 156,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies Olo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑✓ Yes o EIDon'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? QYes 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 o Don't know <br /> 7. Is this to correct a violation? ❑Yes Bo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ —► <br /> 545-112(aros) <br />