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ZONING PERMIT APPLICATION www.countyofdanc.coln SUPPLEMENT-a.--'- App ? <br /> PROPERTY•OWNER;;INFORMATION rUU•_YV,nt } r % CUSTOMER TO PROVIDE <br /> OWNER NAVE,. <br /> 1-"e--1*) <br /> e— -rot I, ( al r C oning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) - Deed Restriction; CSM <br /> Z4 cG <br /> ( , e4t— L: +1 fi Variance(# - ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> C o b —6 .s 3 GQ8'250,0'..4.'-07-- •J ac h OJ e._, u., . 'airy\ I elan drawn to scale <br /> AGENT;INFORMAT104, ``_ ` CONTRACTORgINFOR1 lA,T10N � , and includes dimensions ` <br /> AGENT NAME �j, -CONTRACTOR NAME <br /> (-C V 3 r, P. Fe, I I t t 17c i!Hc,f t -D-cciom/Remoottlw rcks . <br /> Ite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS I I of well/septic <br /> 2-35 J `c✓Son '‘.7.-i J <br /> (City,State,Zip) S�o36 (City,State,Zip) etbacks <br /> 'rnl�r,5otn Cr- vi <br /> •J PHONE / PHONE II Sit proval from <br /> q 2-0 5—q 3 7,1- a ' ab township. <br /> E-MAILADDRESS E-MAILADDRESS <br /> .1 .11I•n I.LI 6, .0 u oor pl s to scale <br /> PROPERTY/LOCATION INEORIIAATIONr'(ht tpa/aeeessiiane.co,dane:vin.us/) ; E4_ vation of <br /> PARENT PARCEL NUMBER: CURRENTZONING property ACREAGE: <br /> 0 PARCEL rontage drawn to scale. <br /> NUMBER •6 0 G aN a 00 o g 1-/-e> <br /> TO S IP: S TION:1 ^ ' t <br /> 1\ - 1\1 p ./' ^J—S 1 ' : I 1 ►'•/ 1/4'/4: ❑Drive y mits <br /> ADD s: J J (stat , unty,town) <br /> G��" �C ❑San.tary - mits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (publi •rivate) <br /> PROPOSED PROJECT:INFORMATION ` -, ' = <br /> ai Rfr7IEW . <br /> PROJECT D rCRIPTIO N: tt 'b` <br /> 0 r CliN �" nP r II� c74)Oi /) 4-n C V na •�rsir 1 _ <br /> , <br /> . ❑This project is a new building or_structure. -&�3y� ' <br /> P Ifted Use= - <br /> [Rfhis project is an addition/alteration to an existing building or structure. s= — M ' <br /> SANITARY SERVICE: PERMIT NUMBER: F! tr:IJJalrA dre55 r. ' - <br /> EWER EPT1C 'N} 5.� k. 3-t t.r sit_-c <br /> HEIGHT IN FEET NUMBER OF S ORIES: (Not including basement) 4s°` -- <br /> -'-'1 i _I letla i/F �•ptain ¢ � . <br /> LT hp .• -#tacfiijr e <br /> AREA TO NEAREST SQUARE FOOT 1 --1.:Z." .:_'":' ` 1P <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) '"= - <br /> )0� 05l tlso-e9tr• perart aZi <br /> BASEMENT 1ST FLOOR: r� v_ <br /> 1-- , TOTAL SQUARE FOOTAGE: , 4 rJpeS 4.,.4___,Uy 241C.� . ..y . <br /> CJ `' <br /> = acce , I--- .•2ND FLOOR: 3RD FLOOR: I ' �� r —s _- <br /> L I/ _ <br /> li r } attongs *1' <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ -� i Ali aliia'ae O s -_ <br /> (Please round to nearest dollar) "r SOO - � y=, . �� <br /> - . . � <br /> a <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑No.- ❑Don t-knbw <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes f No ['Don't know - <br /> 3. Have you talked with the township about your project and are they in agreement? :Yes ❑No. <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes - ONO . - • <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 ❑No - ❑Don't know <br /> 7. Is this to correct a violation? - ❑Yes ❑No <br /> - <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -I. -f <br /> 54t-112 OMB) - <br />