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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Dale Seidel <br /> ['Zoning UP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) De striction; CSM <br /> 501 Windmill Road Brooklyn, Wisconsin 53521 ante(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)455-8391 (608)577-4268 daleseidel @charter.net Si e Plan drawn to scale <br /> AGENT INFORMATION ' CONTRACTOR INFORMATION d includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Bavery Building,LLC Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS Of ell/septic <br /> N8915 Whi#e Street <br /> (City,State,Zip) �� (city,state,Zip) etbacks <br /> Belleville,Wisconsin 53508 <br /> PHONE PHONE ❑Site Plan val from <br /> (608) 516-3500 pli a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> oor plans to scale <br /> PROPERTYILOCATION INFORMATION (http:Ilaccessdane.co.dane.wi,usl) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p rty <br /> Irg PARCEL 0510-302-8000-8 RH-1 '(fp 20.00 frontage drawn to s le. <br /> NUMBER w ,/� <br /> TOWNSHIP: SECTION: N tki l <br /> Rutland 30 -1/4: ..N E 1/a 1/a: ' ►" ❑Driveway its <br /> ADDRESS: (state unty,town) <br /> 501 Windmill Road ❑Sanita --rmits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (pub" ,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Storage Shed X /1-3 . Wing District <br /> . 19 This project is a new building or structure. Permitted Use? <br /> ❑This project is an addition/alt 'on to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: LI Rural A <br /> EWER PTIC �� (new/ xisting) <br /> HEIGHT IN FEET: ( NUMBER OF STORIE (Not including basement) <br /> ❑ Wetlan plain/ <br /> Sh and (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErOSIOt1C permit <br /> BASEMENT: 1ST FLOOR: <br /> �,1 G0- 8^/I 1 4 TOTAL SQUARE FOOTAGE: $, (slopes isturbance, <br /> �L fills access) <br /> 2ND FLOOR: 3RD FLOOR: 471-6070 1�+�� R ' <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: an. available options. <br /> $ <br /> (Please round to nearest dollar) ♦ -♦ -♦ -♦ -♦ $ 13,300.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ' es 1 Don ow�� <br /> ' o <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? cares OW <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes OW <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 alo ❑Don't know <br /> 7. Is this to correct a violation? :Yes ao <br /> 4 I � <br /> �` APPLICATION MUST BE SIGNED <br /> 545-112(4/08) ` (Continue on Back) -► <br />