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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 /> Roger Benda Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 3382 Bailey Rd Sun Prairie,WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)576-9081 tleeser @clearybuilding.com EL ite.pran drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Same Cleary Buildings ite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) tbacks <br /> Verona,WI <br /> _ <br /> PHONE PHONE ❑Site P an provalfrom <br /> (608) 379-0132 applic township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tleeser @clearybuilding.com or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) vatlon of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p p y <br /> ❑PARCEL 058/0811-302-8410-4 A-1 EX y.449- 4 9 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Sun Prairie 30 14. NE 1/41/4: NW II Dri a ermits <br /> ADDRESS: (state unty,town) <br /> 3382 Bailey Rd Sun Prairie, WI <br /> CSM: LOT SUBDIVISION BLOCK/LOT II <br /> ermits n ' <br /> (pivate) / v <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 24x32 Shed "Zoning District <br /> . 15I This project is a new building or structure. Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. -.p J'C � <br /> ,,/ <br /> SANITARY SERVICE: PERMIT NUMBER: U(al Address <br /> EWER [EPTIC (ne existing <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> )1 S 19.3 1.0 - -nd/F ..dplain/ <br /> Shor- :n. _ttachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> E•. .•. .ntrol permit <br /> "'7 6 sr + TOTAL SQUARE FOOTAGE: ,, (slop-:, dis . bance, <br /> ` fillir 6/access <br /> 2ND FLOOR: 3RD FLOOR/ <br /> 768.0 <br /> Review Loc on Survey <br /> ESTIMATED CONSTRUCTION COST: and a • options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ $ 25,000.00 <br /> \..i ii <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes ONo ❑Don"Clcnow <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes nNo nDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? ❑Yes 4No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes '4No <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) nYes igNo ❑Don't know <br /> 7. Is this to correct a violation? nYes jNo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) - - -+ <br /> 545-112(4/08) <br />