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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 /> Scott J. & Cheryl A. Wilson <br /> Fd Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2861 Henshue Rd.Madison, WI 53711 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)575-7790 (608)575-7790 scwilson @wilsonwoodcraft.com <br /> 12 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Same as Owner Wilson Woodcraft Inc. 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2861 Henshue Rd. <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Madison, WI 53711 <br /> PHONE PHONE El Site Plan approval from <br /> (608) 575-7790 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> scwilson @wilsonwoodcraft.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevation of property <br /> ❑PARCEL 0610-071-8225-0 R-1A 1.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Dunn 7 �/4: NE 1/41/4: NW 0 Driveway permits <br /> ADDRESS: (state, county, town) <br /> 2824 Dorothy Dr. Madison, WI 53711 <br /> CSM: 11 916 LOT 1 SUBDIVISION BLOCK/LOT <br /> III <br /> Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: / �{ x r <br /> In Ground Swimming Pool 3 X I �O ❑ Zoning District <br /> . 4 This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: CI Rural Address <br /> FIEWER [EPTIC (new/existing) <br /> HEIGHT IN FEET. NUMBER OF STORIES: (Not including basement) <br /> 0.0 0.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) 1--k ErosiOnContrdl permit <br /> BASEMENT: 1ST FLOOR: <br /> 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 592.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) -' -' —' ♦ —' $ 31 ,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ❑No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ONo EDon'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 rdNo <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 IN 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(4/06) <br />