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a <br /> 't-7,b <br /> SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Scot Ulrich ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6507 Harvest Moon Ct,Waunakee,WI Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)268-6287 (608)206-4580 sulrich @kraft.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> N/A Self ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 0 PARCEL 090936321760 Residential a 0.34 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Vienna 36 1/4: SW 1/41/4. NW ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 6507 Harvest Moon CT, Waunakee, WI, 53597 <br /> ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT (public,private) <br /> 28 Nature Valley Neighborhood <br /> PROPOSED PROJECT INFORMATION iTAFF RE <br /> PROJECT DESCRIPTION: <br /> Outdoor Deck attached to the back of the House Structure ® Zoning District <br /> ❑This project is a new building or structure. LI Permitt se <br /> r4This project is an addition/alteration to an existing building or structure. <br /> Rurat Addre <br /> SANITARY SERVICE: PERMIT NUMBER: Li prf�' 1N/fiXISt1 t <br /> EWER [EPTIC 1 nF <br /> HEIGHT IN FEET: o O NUMBER OF STORIES: (Not iinncluding basement) <br /> AREA TO NEAREST SQUARE FOOT: ) f 5t <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) .EfosiorlControl permit <br /> BASEMENT: 1ST FLOOR: 224.0 I TOTAL SQUARE FOOTAGE: t�s,disturba , <br /> '+ ♦ fittss) <br /> 2ND FLOOR: 3RD FLOOR: 22A O <br /> �F <br /> ♦ ♦ ♦ G Rev ueLo n c <br /> ESTIMATED CONSTRUCTION COST: and <br /> (Please round to nearest dollar) ♦ <br /> 2,000.00 , <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes rdNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes CiNo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Ores ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes ❑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) Eves alo ['Don't know <br /> 7. Is this to correct a violation? ['Yes ✓❑No <br /> APPLICATION S BE SIGNED <br /> (Continue on BacMUk)T <br /> 545-112(8/09) <br />