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ZONING PERMIT APPLICATION www.count 'fdane ;SUPPLEMENT to Web App;#,
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<br /> PROPERTY OWNER.INFORMATION - CUSTOMER TO PROVIDE
<br /> OWNER NAME
<br /> AIdiL of40g) C-A11)(F ' III Zoning S0► - • ' /2.......
<br /> OWNER ADDRESS (Number,Street,City,State,Zip)
<br /> Deed Re: � 1, CSM
<br /> fIZ 17451.2vF1 r C-T C,, -CLC /Y0,0r1 t-0 S.?S"-) Z Variance(# 7 2
<br /> HOME PHONE CELL PHONE E-MAIL ADDRESS
<br /> v_
<br /> 32 -- Z/ • f n Site Plan�dvn to scale
<br /> AGENT!INFORMATIO�I . ,.` _ „.`i CONTRACTOR INFORMATION `i;: and inclu es dimensions
<br /> AGENT NAME CONTRACTOR NAME
<br /> C tAC/ 1 t-t f; (V„,rr ,,ic.. ;S/s�..,-F ❑Site Plap j4'ding location
<br /> AGENT ADDRESS CONTRACTOR ADDRESS • of well/s ptic
<br /> P t7, 1 a K i Z ,.5
<br /> (City,State,Zip) (City,State,Zip) ❑ Setl s
<br /> Pre,. }1 'R.E( L.v) -c-.rs 7 Z .„„Cows t,�
<br /> PHONE PHONE ❑Site Pla' ale val from
<br /> (Qv 2)- 7?0< 377y .;S-/-"„✓ applicaal- ,• ip.
<br /> E-MAIL ADDRESS E-MAILADDRESS
<br /> q i.>` wes�:„, - ) • c ok i ❑ Floor plan�fo scale
<br /> PROPERTY/LOCATION,;INFORMATION:�s(httpel/accessdane co,dane.wi.us/)_ ' -.' , ��//
<br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevatl n property
<br /> ❑PARCEL frontag yawn to scale.
<br /> NUMBER Rfl TOWNSHIP: SECTION:
<br /> ❑ Dr YPermits S �Y&L PI QCt.,/4( .7z '/4: A'LL '/'/4: f
<br /> ADDRESS: (state, county, town)
<br /> Cr L ❑Sanitary permits
<br /> CSM: LOT SUBDIVISION BLOCK/LOT (public, pI
<br /> PROPOSED PROJECT INFORMATION STAPKREVIEW
<br /> PROJECT DESCRIPTION: r, ; k- f : .
<br /> C o .S,AJ& .� ��rn 1 L/ /7/ o vt.E Doi ;f:', Sid ty f x
<br /> . This project is a new building or structure. '{ r r
<br /> CatPerm d,Iiipi
<br /> This project is an addition/alteration to an existing building or structure. � -
<br /> rosy ,� .1.-7 . litip741.: -� F
<br /> SANITARY SERE: PERMIT NUMBER:4 cu l/ _ (, k_© ^l��dre,SS', L
<br /> (`S 4' �-, n et e i tin )
<br /> EWER EPTIC , . $ i ��
<br /> HEIGHT IN FEET: ( NUMBER OF STORIES: (Not including basement) .k % ,.,_.3 _
<br /> I t 3Q Wetrar d/b I,s �-a-yv'v j..
<br /> . . Pr‘16 Shrelad�T tme )
<br /> AREA TO NEAREST SQUARE FOOT = - ` - F v
<br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) t -� -4
<br /> BASEMENT.' 1ST FLOOR: �i- Cosio C-on r°1°-rmjt- {
<br /> n -^:.r�s. x-7 e z as
<br /> L O ' 4, TOTAL SQUARE FOOTAGE 4, s 1,'_", 4' '
<br /> RoSCOx e';
<br /> 2ND FLOOR: 3RD FLOOR: 2.dq cli Cc Reu% ai ea; ;$
<br /> ESTIMATED CONSTRUCTION COST: it rfa t'. 6 e lit
<br /> (Please round to nearest dollar) '� ' ♦ ♦ -* -* $ on 0 ®©U lw �,�,� ,_
<br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes ONo • ODon't_know
<br /> 2. Is there a wetland or floodplain on or near the property? <E5Yes ONo ❑Don't know
<br /> 3. Have you talked with the township about your project and are they in agreement? ifYes ONo.
<br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes ENO .
<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 QNo ['Don't know
<br /> 7. Is this to correct a violation? [Yes QNo
<br /> APPLICATION MUST BE SIGNED
<br /> (Continue on Back) —► —► —►
<br /> 545-112(4/08) .
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