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ZONING PERMIT APPLICATION www.cotinyo#dane.cotm SUPPLEMENT to Web-App tt <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME PAUL TUITE Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 6257 MARY IDA DRIVE,DEFOREST,WI 53532 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)576-8441 LATOUR.TAMMY@COUNTYOFDANE.COM 0 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> CLEARY BUILDINGS I TRAVIS LEESER [Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 190 PAOLI STREET <br /> (City,State,rp) (City,State,zip) ❑Setbacks <br /> VERONA,WI 53593 <br /> PHONE PHONE O Site Plan approval from <br /> (608) 379-0132 applicable township. <br /> E-MAIL ADDRESS E-NWLADDRESS <br /> TLEESER @CLEARYBUILDING.COM 0 Floor plans to scale <br /> PROPERTY LOCATION INFORMATION (http: accessdane.co.dane.wi.us) O Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE <br /> [PARCEL 0810-032-1421-4 R1 0.97 c frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> BURKE 3 1h: NE WA: NW 0 Driveway permits <br /> ADDRESS: 6257 MARY IDA DRIVE (sue,county,town) <br /> CSM-. LOT SUBDIVISION BLOCK/LOT ❑sanitary permits <br /> blic,private <br /> TERRACE PARKLAND OUTLOT 1 (pu ) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> GARAGE ❑ Zoning District <br /> - o This project is a new building or structure. ❑ Permitted Use? <br /> OThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: �� PERMIT NUMBER: CI Rural Address <br /> nEWER I-r P'-P (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not in4udnp basement) <br /> 15.8 1.0 ❑ WetlarnYFloodplain/ <br /> AREA TO NEAREST SQUARE FOOT: ShOreland (attacfttrlent) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErosionContro)permit <br /> BASEMENT 1ST FLOOR: Z 3 C2-- , TOTAL SQUARE FOOTAGE: , (Slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filing/access) <br /> 2-3 Z ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST _� _r .,� 59 000.00 and available options. <br /> (Please round to nearest dollar) , <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes 0 • ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes 4 • ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes U o <br /> 4. Has there been a zoning permit issued for this property in '►: = - 5 years? [Yes [lo <br /> 5. Is this project associated with a rezone/CUP/variance •- , 1• appeal# Z (leave blank if none) <br /> 6. Is a location survey required? (see reverse) [Yes Odo [Don't know <br /> 7. Is this to correct a violation? [Yes ✓}Io <br /> APPLICATION MUST BE SIGNED <br /> 545-112 OM (Continue on Back) ■ -► <br />