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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 /> / David & Laura Doyle <br /> o <br /> / OWNER ADDRESS (Number,Street,City,State,Zip) irus; CUP; <br /> VVV 5274 Ridge Rd Marshall WI 53559 Deed g Reeststriction;CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)445-9361 Ikdoyle124 @gmail.com elan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION `-Wand includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Recreational Concepts Inc Recreational Concepts Inc to Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1 1 N Main St 121 N Main St <br /> ity,State,Zip) (City,State,Zip) Se acks <br /> Oregon WI 53575 Oregon WI 53575 <br /> PHONE PHONE El(608) 835-2780 (608) 835-2780 appli township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> recconinc @ymail.com recconinc @ymail.com ❑Floor ns to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Ele o property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 036/0812-302-8630-6 A2(8) 8.75 fro a drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Medina 1/4_ 1/41/4_ ❑Driv- ay .-rmits <br /> ADDRESS: (state, •. nty,town) <br /> 5274 Ridge Rd Marshall WI 53559 <br /> csM9 'LOT 1 SUBDIVISION BLOCK/LOT <br /> El Sanit: ■ p its <br /> 3 (pub!"., . ivate) <br /> PROPOSED PROJECT INFORMATION STAFF -EVIEW <br /> PROJECT DESCRIPTION: <br /> Above Ground pool 18'x 33'with deck y {,,,� 0;4c/C �I'� onin District <br /> . INIThis project is a new building or structure. rmitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT�vUMBER ❑ Rural Address <br /> FIEWER f'� (newt- �+ e <br /> HEIGHT IN FEET: S NUMBER OF STORIES: (Not including basement) <br /> `� � <br /> etlan I oodplain!CVIL5tk_ <br /> IShore nd (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimension including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST F OR: rosionCOntrolpermit <br /> �� ,, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 3RD FOOT <br /> fillin /access) �/� <br /> 1."�� eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ $ ]i and available optidi <br /> (Please round to nearest dollar) $ OK <br /> /VP <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ONo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes ❑No El <br /> Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? ['Yes EINo <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 ao ['Don'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 />