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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 Ing Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) eed 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 Site Ian drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> John Wirrwefurth ©,SttPlan including location <br /> JADDRESS CONTRACTOR ADDRESS of well/septic <br /> 9491 Donnette Dr �ate,Zip) (City,State,Zip) I� I Jfd'[Dacks <br /> Sauk City Wi �/ <br /> PHONE PHONE ❑Plan approval from <br /> (608) 333-2619 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jlwipperfurt@wisc.edu oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) evation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P Y <br /> ElPARCEL 0906-213-9330-6 R-1 1.38 frontage drawn to scale. <br /> MBER <br /> TO SHIP: SECTION: <br /> Mazomanie 90,621 1/4: sw + IA: SW Ziptiveway permits <br /> N (state,county,town) <br /> DDRESS: <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanl mlts/ ,z, <br /> 6,155 1 CSM 06155 ( ic,private) <br /> PROPOSED PROJECT INFORMATION TAF.FREVIEW= <br /> PROJECT DESCRIPTIO <br /> 3o X s oriing Dist- <br /> This project is a new building or structure. ' anted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: oral Address <br /> EWER [EPTIC 132,016,000,230 (new/ ' <br /> HEIGHT IN FEET. NUMBER OF STORIES: (Not including basement) <br /> I 1 \ Off 1.0 Wetla ,_ dplaint <br /> Shoreta N ttach ant) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ErOS10n6Ontr01 permit <br /> 1,770.0 ,, TOTAL SQUARE FOOTAGE: ,, (Slopes,disturbance, <br /> fill' /access <br /> 2ND FLOOR: 3RD FLOOR: <br /> 1,770.0 <br /> eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available. tons.. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ $ 1 0,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes 12 No DDo15 t know <br /> qZ <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes tg No DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes QNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes Is No <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 DNo DDon't know <br /> 7. Is this to correct a violation? Dyes tg No <br /> APPLICATION MUST BE SIGNED <br /> 545-112 laiosl (Continue on Back) -4 -4 <br />