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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME A...... <br /> / <br /> Joseph R. Ripp <br /> 4 Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6756 Old 113 Road <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-4596 Site Plan drawn to scale A., <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> All <br /> AGENT NAME CONTRACTOR NAME /v�-iW <br /> Mervin Bontrager <br /> IN Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> W2432 County Road E <br /> (City,State,Zip) (City,State,Zip) io Setbacks 63/30/49/0 <br /> Cambria WI 53923 <br /> PHONE PHONE io Site Plan approval from <br /> /V y <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> 51 Floor plans to scale rr <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) i0 �� <br /> PARENT PARCEL NUMBER: CURRENT ZONING ACREAGE: Elevation of property <br /> 0 PARCEL 0909-193-8500-1 A-1 Ex Agriculture 38.90 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Vienna 19 '/,: SW 1/41/4: NW A Driveway permit — <br /> ADDRESS: (state,county, own <br /> 7004 Old 113 Road <br /> CSM: LOT SUBDIVISION BLOCK/LOT 12 Sanitary p= <br /> (public, • ivate) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 84'x 64'x 29'corn fodder storage shed <br /> 4Zoning District A ) .4 <br /> . ri This project is a new building or structure. APemlitted Use? `'© ,i <br /> This project is an addition/alteration to an existing building or structure. ti,," <br /> SANITARY SERVICE: PERMIT NUMBER: ,Rural " ,.,. <br /> EWER PEPTIC (new/-∎ isti g) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not induding basement) <br /> 29.0 1.0 - .•/ Ioodplain/ 4g:1. <br /> AREA TO NEAREST SQUARE FOOT: oral-rid -cFlment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: rosionCOntrol permit t A <br /> 5,376.0 + TOTAL SQUARE FOOTAGE: 1, (slopes,disturbance, ' r� <br /> ' filling/access) A yt/ /, <br /> 2ND FLOOR: 3RD FLOOR: <br /> 5,376.0 <br /> J <br /> af Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. /� <br /> (Please round to nearest dollar) -� -� -+ -' -' ♦ $ 65,000.00 <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? ❑Yes ❑No DDon'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? ❑Yes ❑No <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 ENo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -+ -► <br /> 545-112(4/08) <br />