Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdanc.com :k �pp'LEMENT}to Web�App#= <br /> 'IPROPERTY`OWNER'INFORMATION _r,t ?_`�{ Ziti- .1j_MNA __ �, ,- : CUSTOMER TO PROVIDE <br /> OWNER NAME / •A 4�/ ✓ - a. �r'ktt• <br /> n Zoning Status; CUP; <br /> OWNER DD/RESS (Number,Street,City,Stat.,Zi.) n Deed Restriction; CSM <br /> `ASS I - IV l lr , C.Olt vS WI 5347Z5— Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 608-857- 865' free,5 G O . 4.00.c...c'M El Site Plan drawn to scale <br /> AGENTtINFORM A TIO�I;l•_, �r „ � 5„-m rCOWTI ACT�IR A1614 and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> —04,,..."/• kCAPle...1A5 Lar(Lw000l sii,Wes n Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 4455- Muller- <br /> (City,State,Zip) . (City,State,Zip) n Setbacks <br /> CIU+hLs WI 6391-6- <br /> PHONE PHONE n Site Plan approval from <br /> X08 —gsz -C8. L/ applicable township. <br /> E-MAILADDRESS E-MAILADDRE S - <br /> • 1611'. 6vila�r_r+S a0 • h o.cpw.. n Floor plans to scale <br /> `PROPERTY/LOCATION INFORMAT1ONi (http//accessdane co,danelwi.us/)y ._"s j 4, rl Elevation of property <br /> PARENT PARCEL NUMBER: • CURRENT-ZONING: ACREAGE: <br /> ❑PARCEL ,t ii) frontage drawn to scale. <br /> NUMBER CeiI2-1442- 806'0'.$ EN-�2 S•l l <br /> TOWNSHIP' - SECTION: <br /> yorle i/4: i/4%4: ❑Driveway permits <br /> ADDRESS: mutter. ' 1 (state,county, town) <br /> csM: '/ss m u`�T a Ot s Boos cal I 51 BLOCK/LOT n Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT=INFORMATION __ '$T F tirEVIEVV <br /> PROJECT DESCRIPTION: m.' 7 <br /> Ig K IS tall Ccov.^- Ade)11-iby. (AV 1,00A14-otA. 101kZe-rit Lm-77€41-1' 0 al 06-4--, ta------ <br /> • ❑This project is a n w building orstructure. gLP I ed Us �� `'` <br /> F <br /> NIThis project is an addition/alteration to an existing building or structure. f z �a <br /> SANITARY SERVICE: PERMIT NUMBER: • 1= "b'a .�e � :.:W-._ <br /> " k <br /> EWER F)EPT1C c. r f lr S6 ' 4trac <br /> HEIGHT IN%FEET: NUMBER OF STORIES: (Not including basement) 4 > <br /> AREA TO NEAREST SQUARE FOOT ._� � <br /> �-� T"t '�''; ,. .tom <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) -. '°1 .*. <br /> D a e r• per n T-4• <br /> BASEMENT: 1ST FLOOR: i ^-'� 4 :,a <br /> 1 TOTAL SQUARE FOOTAGE: <br /> 32 s�' 3Z4 s-F y o -it, 4 <br /> 2ND FLOOR: 3RD FLOOR � <br /> r.41-z• --...,,I3,---.7"•=.: <br /> 'W r evi cre6 .p yam. <br /> • <br /> ESTIMATED CONSTRUCTION COST �, � P, <br /> (Please round to nearest dollar) -O. '♦ "'� -i "i -t> 41O 000 ...-s = i <br /> 9S.. . . <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes. ' $r4No.•• nDon't-know <br /> ❑ <br /> 2. Is there a wetland or floodplain on or near the property? Yes ❑No Don'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 • �lo • . <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 ®No • ❑Don't know <br /> 7. Is this to correct a violation? Elves No . <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) --s -s -is <br /> 545.142(4108) - <br />