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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 /> Heffron Homes, Inc. Zoning Status; CUP; <br /> Is OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2000 Prairie Street Suite 220,Prairie du Sac,WI 53578 Variance(# ) <br /> HOME PHONE I CELL PHONE E-MAIL ADDRESS <br /> (608)643-8525 (608)963-6022 heff @heffrongroup.com isi Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Daniel Heffron Heffron Homes, Inc. 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2000 Prairie Street,Suite 220 2000 Prairie Street,Suite 220 <br /> (City,State.Zip) (City,State,Zip) IS Setbacks <br /> Prairie du Sac,WI 53578 Prairie du Sac,WI 53578 <br /> PHONE PHONE 0 Site Plan approval from <br /> (608) 643-8525 (608) 643-8525 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> heff @heffrongroup.com heff @heffron group.com Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) 0 Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 0907-184-4650-0 R-1 0.65 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Roxbury 18 /,; SW 1/414. SE Is Driveway permits <br /> ADDRESS (state,county,town) <br /> Jenny Lind Lane <br /> CSM '-F <br /> LOT ^0 SUBDIVISION BLOCK/LOT 0 Sanitary permits <br /> Black (public,private) <br /> lack Hawk Fields <br /> PROPOSED PROJECT INFORMATION STAFF REVIE <br /> PROJECT DESCRIPTION: <br /> New Home Construction Zoning District <br /> . <br /> This project is a new building or structure. Permitted Use?S/ g <br /> ['This project is an addition/alteration to an existing building or structure. I <br /> SANITARY SERVICE: PERMIT NUMBER: X R- r Address 7 g�'4 <br /> [VIEWER rEPTIC 517,869 -xisting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 28.0 2.0 XWetland/Floodplain/ /4— <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) f•-•--BASEMENT 1ST FLOOR: <br /> ErosionControl permit % Q <br /> .98'6i0 I o$3 1 ,976.0 j TOTAL SQUARE FOOTAGE: 1 (slopes,disturbance, ie / rl <br /> 2ND FLOOR 1 180.0 3RD FLOOR: O O4 { filling/access) J 44' (�J Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -► _' .- -+ 205'000 00 V` and available options. iv <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes csNo QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes ENo DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? n✓Yes QNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes 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) ®a fNo Don't know <br /> 7. Is this to correct a violation? [Yes ONo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ ■ -► <br /> 545-112(4/08) <br />