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ZONING PERMIT APPLICATION www.countyofdanle.com upptEnnNrar,�w__ a
<br /> 'PROPERTY wNERINFORMATIQN { - ;,_ Y.��_ _��- ; a'�'. -. � ;<�: } CU - OMER TO PROVIDE
<br /> OWNER NAME ,j,.,
<br /> 64,7 s / e9�+G Zo ing Status; CUP;
<br /> OWNER ADDRESI(Number,Street,City,State,Zip) 1 D ed Restriction; CSM
<br /> A S. 3 L ro Ss £Q ufr1'7C'I C/ r•-,k_. ri nce(# , -- )
<br /> HOME PHONE CELL PHONE E-MAIL ADIMESS ,
<br /> sR ' '5'137 e Plan drawn to scale
<br /> 'AGENT(INFORMATION ," 2 ,_I;' .sr;,,3 rCONTItAGTOtt"INFOR,. 10:N z r}
<br /> � `hil �- nd includes dimensions
<br /> AGI49//ME CONT CTOR NAME
<br /> S9-4 de f , (/`'�,�jv 604ce f s Site Plan including location
<br /> AGENT ADDRESS CONTRACTOR ADD S of well/septic
<br /> /S-O) 8/'oo•(S 1 de Z48/7e 1SOO 8/404 s/ k 61-me
<br /> (City,State,Zip) (City,State,Zip) ❑Setbacks
<br /> Gt14r u/MEe G / i• W4vn4 k- - Gr/
<br /> PHONE PHONE ❑ ite Plan proval from
<br /> 575-- 329'x" S.?5-- ?.2-T" ap li le township.
<br /> E-MAIL E-MAIL ADDRESS -
<br /> ( bci eiC j 2Q :Jn yt,i ems'! S b cg.n< / & - 4..,./ .off loor plans to scale
<br /> `.PROPERTY/LOCATION INFORMAT ION .(httpJ/accessdane.co,dane: i.usl y g � ��
<br /> CR �)��'_-. ._s.� Elevation of property
<br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACR GE:
<br /> ❑PARCEL G /�C �^ / - frontage drawn to ale.
<br /> NUMBER 04,0*05"718 60 i' g_+ast3 �i ���.
<br /> TOWNSHI : SEC N:
<br /> G/eioii s. ,/: S E ,/4,/4: A.) Vj ❑ Drivewa rmits
<br /> ADDRESS: (stet Ounty,t• , )
<br /> a 3 , _ as i d S/y Cl%L/ ❑Sanita •ermits
<br /> CSM: LOT SUBDIVISION BLOCK/LOT (g • • private)
<br /> PROPOSED PROJECT INFORMATION _, 'STAIF,R ' E' '
<br /> PR JECT DESCRIPTION: i :
<br /> '� f (Sl'cen /rA �lcl �iorr 1 k 7EF �n-, ;� NAP -- -?
<br /> ❑This project is a new building or structure. -brmrf d t. U-�
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<br /> This project is an addition/alteration to an existing building or structure. w^° ,_7_ _ Y . _
<br /> SANITARY SERVICE: PERMIT NUMBER: ' •• -, Ya
<br /> . EWER . EPT1C ' s6__>� . `E-*.',
<br /> HEIGHT IN FEET NUMBER OF STORIES: (Not includi g basement) 4_ - =7
<br /> // • f . / M' g °iYe-aeeo Ii,A. s
<br /> AREA TO NEAREST SQUARE FOOT qw „T- -
<br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) - 747-`'4 %-
<br /> BASEMENT 1ST FLOOR: r! � D e s 2 ' -
<br /> /� i s S•, .'y . . zi t •!� sr. .I� j• TOTAL SQUARE FOOTAGE: ,l ° 4 s:- 1 'i'-Y
<br /> 2ND FLOOR: •� 3RD FLOOR7: 1Wir. „.,
<br /> _• ... Y/ mss,,E - _Y -� ms's.{ ,
<br /> •
<br /> ESTIMATED CONSTRUCTION COST: —1z
<br /> (Please round to nearest dollar) "+ "* ♦ /"A 0 Q DD _ p Q '{ e - z '
<br /> 1, y. . "
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<br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes o.- ❑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 ❑No - - _
<br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes : I: • - .
<br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank' one)
<br /> 6. Is a location survey required? (see reverse) [Yes i • ❑Don't know
<br /> _____..(14,
<br /> 7. Is this to correct a violation? ❑Yes `, o .
<br /> 7 '5;2 0 . . APPLICATION MUST BE SIGNED
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<br /> 5455192(4108) r
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