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I <br /> i <br /> ZONING PERMIT APPLICATION www.countyofdane•ean SUPPLEMENT to Web-App # <br /> 4 PROPERTY OWNER INFORMATION <br /> OWNER NAME Joseph Ripp CUD • MER TO PROVIDE <br /> c OWNER ADDRESS(Number,Street,City,State,Zip) II oning Status;CUP; <br /> ■ 6756 Old 113 RD,Dane,WI 53529 Deed Restriction;CSM <br /> ? HOME PHONE CELL PHONE nonce(# ) <br /> i E-MAIL ADDRESS <br /> • 608849-4596 60513-7610 Si a Plan drawn to scale <br /> AGENT INFORMATION <br /> AGENT NAME CONTRACTOR INFORMATION d includes dimensions <br /> CONTRACTOR NAME <br /> Chris AWtman Morton Buildings,INC to Plan induding location <br /> AGENT ADDRESS f well/se tic <br /> s CONTRACTOR ADDRESS <br /> i 411 E Leffler ST 411 E Leffler ST p <br /> I (City,State,Zip) <br /> (City,State,Zip) Setbacks <br /> Dodgeville,WI 53533 Dodgeville,WI 53533 <br /> PHONE PHONE ❑ e approval from <br /> 608-574-5987 608-935-2384 pli ble township. <br /> i E-MAILADDRESS E-MAILADDRESS <br /> i <br /> j chris.auttman@mortonbuNdings.com toot plans to scale <br /> I PROPERTY LOCATION INFORMATION (http:,laccessdane.co.dane.wi.us') <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: Elevation of property <br /> I 117 <br /> NUMBER 0909-193-8500-1 A-1 36.9 frontage drawn to le. <br /> TOWNSHIP. SECTION: <br /> Vienna 19 %: SW '/%: NW ❑Drivew <br /> ADDRESS: county • " ) <br /> 7004 OLD 113 RD, DANE, WI <br /> 1 CSM: LOT SUBDIVISION BLOCK/LOT ❑Sa permits <br /> f` (• ,private) <br /> PROPOSED PROJECT INFORMATION AFF REVIEW <br /> PROJECT DESCRIPTION: <br /> ADDITION TO EXISTING BUILDING,EQUIPMENT STORAGE O 4 )1.(I? D Z• ing District <br /> . ❑This project is a new buildin or structure. <br /> O Permitted Use? <br /> QThis project is an addition/ Iteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural • .1 •---: <br /> EWER TIC (new/,xisting) <br /> HEIGHT IN FEET: NUMBER OF STORES: including basement) <br /> 27 1 ❑ Wetla • v..'plain/ <br /> AREA TO NEAREST SQUARE FOOT: Sho • nd (attadtm <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionCont it <br /> 5376 4 TOTAL SQUARE FOOTAGE: 4 (slopes • rbance, <br /> 2ND FLOOR 3RD FLOOR: flltll ) <br /> 5376 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. lJ <br /> (Please round to nearest dollar) '♦ -. -* "+ '♦ -r $ 90000 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes lab ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes B lo [pon't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes io <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Efres clo <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) Dees c}Jo ['Don't know <br /> 7. Is this to correct a violation? [Yes ONO <br /> APPUCATION MUST BE SIGNED <br /> 5.5-112(4108) (Continue on Back) --e- -► <br />