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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 /> John & Janet Wipperfurth Oning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 9491 Donnette Dr Sauk City Wi. Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)333-2619 jlwipperfurt@wisc.edu Sit n drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION nd includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> John Wipperfurth a Plan including location <br /> AGENT ADD E CONTRACTOR ADDRESS of well/septic <br /> 9491 Donnette Dr <br /> (City,State,Zip) (City,State,Zip) bac <br /> Saukk City Wi 53583 <br /> PHONE PHONE Ite Plan approval from <br /> (608) 333-2619 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jlwipperfurt@wisc.edu or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) evation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: '— I ACREAGE: P P y <br /> ❑NUMBER 0906-213-9330-6 Niel D 4�, 1.38 frontage drawn to scale. <br /> T WNSHIP: SECTION: <br /> Mazomanie 90,621 1/4: sw +/4+/4: sw riveway perm e •-62 ADDRESS: (state,COU t0 <br /> Laws Drive I Q J e*'' <br /> anitary permits �� 'E✓t <br /> CSM. 6 155 LOT 1 SUBDIVISION BLOCK/LOT (pub 1, �8A <br /> CSM#06155 <br /> PROPOSED PROJECT INFORMATION ST REVIEW <br /> PROJECT DESCRIPTION: f <br /> New House/with attatched garage i� / jC k nmg District . <br /> This project is a new building or structure. rmltted..Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 13 ddress <br /> EWER PEPTIC 13,201,600,230 ((nr,�G�tli7tisting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> pV5 Q'S 1.0 16.0 - nd/Floodplain/ <br /> hore •,: achment } <br /> AREA TO NEAREST SQUARE FOOT ea do's <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionC•I. • •ermit <br /> 1,343.0 2,484.0 ,l TOTAL SQUARE FOOTAGE: ,, (slope- •isfurbanc- <br /> 2ND FLOOR: 3RD FLOOR: fII g/aCC2SS <br /> 3,827.0 <br /> eview ocation Survey <br /> ESTIMATED CONSTRUCTION COST: and avajla O tions. <br /> (Please round to nearest dollar) —' ♦ ♦ -, ♦ ♦ $ 180,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Elves ES No Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes 12 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 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) ❑✓Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes cs No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —+ —+ —* <br /> 545-112(4/08) <br />