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• • <br /> . <br /> 4 DANE COUNTY - APPLICATION FOR ZONING PERMIT <br /> LOC ATI ON <br /> .....Z: z ga s c. C , ca -r TA 5-ri Cfz c v ri S7 E C S' —r'SE <br /> -NUMBER ROAD TOWN <br /> LOT M NU <br /> A SUBDIVISION NAME OR C. S. M. NUMBER C.U.P. # ZONEI <br /> TYPE OF IMPROVEMERI PROPOSED USE <br /> C 1 New building C 1 001 One family bldg C 1 013 Sery sta/garage <br /> Addition C ] 002 Two family bldg C 1 014 Hospitals/institutions <br /> C 1 Alteration C 3 003 Three/four family bldg C 1 015 Office/professional <br /> C 1 Repair/replacement C 1 004 Five/more family bldg C 1 016 Public works/utility <br /> C 1 Moving/relocation C 3 006 Transient hotel/motel C 1 017 Schools/educational <br /> TYPE OF FRAME 1 3 008 Amusement/recreational C 1 018 Stores/mercantile <br /> C 1 009 Churches/religious C 1 019 Other non-residential 1 <br /> Wood frame C 1 010 Industrial bldg C 1 020 Tanks/towers <br /> C 1 Masonry (wall bearing) C 1 011 Parking garage .14' 021 Add/alt residential <br /> Structural steel C ] 012 Residential garage C 1 022 Add/alt non-residential <br /> Reinforced concrete PROPOSED USE (If non-residential, describe in detail) <br /> C 1 Other <br /> CAXA6—S- <br /> SE4AGE DISPOSAL <br /> I I Public <br /> . Private l <br /> Permit # r <br /> DIMENSIONS OWNER 1� <br /> Long /S' Wide 34 /Z ' C`v -T--r, &e ,; ✓c <br /> Stories l Feet <br /> Total floor area <br /> Total lot area CONTRACTOR <br /> t ARKING SPACES <br /> Required The undersigned and the owner of this building agree to conform to <br /> Furnished all applicable ordinances of Dane County. <br /> S21(RELAND/FLOOD PLAIN � =„`t rersit ' nature of owner or his agent Date <br /> ( <br /> VARIANCE INSPECTION RECORD <br /> Permit # Front yard r.- Right yard Left yard ' Rear yard ..--- <br /> :4E121X UNITS (003-004) Date / -'-1 Cf By 019 Certificate issued p!-- _T i By/ 1;6 1 ' *r Notation f <br /> br <br /> 5 tr <br /> Total <br /> PERMIT 0 aZ FEE 44 VOUCHER OR RECEIPT 0 / .el91 DATE 2— 31 - 7V <br /> COST OF WILDING �S`&C, =” Issued by iC� ..:cs <br /> L <br />