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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Dean A. Hahn oning Status; CUP; <br /> , WNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 7400 WIBU Road,DeForest,WI 53532 <br /> \ ariance(# ) <br /> HOME PHONE CELL PHONE E-MAIL E-MAILADDRESS <br /> (608)846-3130 <br /> ite Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> David D.Hahn Same as Agent [Site; }r�Cluding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of w e c <br /> 7 10 WIBU Road <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> DeForest,WI 53532 <br /> PHONE PHONE [Site n royal from <br /> (608) 846-9306 app• township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> daviddh@centurytel.net oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) tlon of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: a P P rty <br /> [PARCEL 0909-094-8000-6 A-1(EX) 40.20 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Vi/ Vienna 9 +/s. NE x/41/4: SE Li Driv= ay • rmits <br /> ADDRESS: (state, • nty,town) <br /> 7569 Patton Road <br /> D Sanita . •• its <br /> CSM: LOT SUBDIVISION BLOCK/LOT (••• c, • ivate) <br /> PROPOSED PROJECT INFORMATION AFF • EW <br /> PROJECT DESCRIPTION: ■ <br /> Removal of existing building and replacement with larger building. St3\ X \!( • oni District <br /> OThis project is a new building or structure. ermitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> =� <br /> EWER [EPTIC (new i�'J <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> '-WO --e e k 1.0 ❑ Weti- • •• •lain/ <br /> •• nd (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl rmit <br /> BASEMENT: 1STI,O R.. <br /> O1 TOTAL SQUARE FOOTAGE: 1 (Slopes, Isturban , <br /> 2ND FLOOR: 3RD FLOOR: fllling/acces <br /> ��, �n J eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: $ . ..c.., /_ and available options. <br /> (Please round to nearest dollar) --► -- --o• '/'�\-- -- <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes O•o Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes alo DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [✓Yes DNo <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 rNo DDon'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 />