Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVID <br /> OWNI'e1ZNAME <br /> ief'4'e.,i ()l <br /> OWNER ADDRESS (Num r,Strep4 City,State,Zip) J�Zoning Status;CUP; <br /> CELL <br /> j eed Restriction;CSM <br /> j <br /> V K H j s d �3 i � ' 4 b. 5.3' Variance(# )H1 ME PONE CL E-MAIL ADORES <br /> 1-66,-c� cf. 5�,, t o i. ol 2p) d- ar koo, <br /> COVt KSite Plan drawn to scale r 1) <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME C9f' RpCTOR E <br /> }L' ( >& 'i.e., I :tie:5 x IgiSi - ' - •• uding location <br /> AGENT ADDRESS C TRACT R ADDRESS <br /> o ell/septi <br /> ^ .Or Eok /0 4 VI DAr .(City,State,Zip) a/"i L e (City.State,Zip) Setbacks <br /> Ct+ ofC- 6/0oc- Gas 53 -2? <br /> PHONE <br /> PHONE Zite Plan approval from <br /> (9 c -2!1-Scf0 applicable township. <br /> E-MAIL ADDRESS E-MAIL A DRE S <br /> 1/t-)a eQ, o,,tt)d 614x1 t C ,.,, 0Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn I / <br /> PARENT PARCEL NUMBER: CU ENT ZONING: ACR E: Elevation of property <br /> PARCEL VI1 2 �1 2 ctciC 'S rontage drawn to ,-. <br /> ID NUMBER X12-J/4-4D22-0 GD <br /> TO NSHIP:�; nn SECT}ON: 1 / <br /> ��I(i-c Fl dt / ,A: S C %.1/4: g L Driveway permit <br /> �s.t/� L // I (state,county, <br /> 7 ♦n) go.,c) rsc_ w / /' p� <br /> CSM: LOT SUBDIVISION CK/LOT IL_T Sanitary <br /> -7y(Z 2- (public,• <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: r /, <br /> NO-00 5,',,,`A C"/1 y A0,4e 0 •l e c Co✓ f r'� Zoning District le 8^ L <br /> This project is a new building or structure. A r S? 6 <br /> Permitted Uses <br /> This project is an addition/alteration to an existing building or structure. 51 le <br /> SANITARY SERVICE: PERMIT NUMBER: 1 1 3 e /,�Ji le ' . I Address <br /> EWER PEPTIC / 3 �— L 7'�/Q 4(r"existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not induding basement) <br /> 2 lG 2 loodplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Sho elan ttachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> T: 9 1ST FLOOR: lrosionControl permit 0,--BASEMEN <br /> / ( 2 y 4 TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, v 0 i <br /> 2ND FLOOR: FS g 3RD FLOOR: "..°A <br /> filling/access) A /, / <br /> Q i/PS-6"(Review Location Survey / <br /> ESTIMATED CONSTRUCTION COST: ♦ -11. ♦ ♦ ♦ 0 ) and available options. A- <br /> (Please round to nearest dollar) 2� <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes a. ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes no ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ®Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? IJYes EN0 <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) (fYes PrPo QDon't know <br /> 7. Is this to correct a violation? JJYes FINlo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) -► -► -4. <br />