DCPZP-2016-00492 - Laserfiche WebLink

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uonrFIiim to 1Neb App" ZONING PERIVIIT APPLICATION www.countyofdanc.com _______________- "`"'"`_____--- ..,..- ROPERTY NN �tm_Vto J "` ,` r r ter ''-. -- -e4 .. CUSTOMER TO O PROVIDE s0 ER.INFO _�.`� a ��- *_r a �_�`T � ��'',-•z��r OWNER NAME /qL Yr /4 .d 4/241h k tasty 1 I Zoning Status; CUP; OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM•7F Y? hv►1 E 2 f/EC D - a it) Variance(# - ) HOME PHONE CELL PHONE E-MAIL ADDRESS _ •Z0 S6� .S�aa, • I Is ite Plan drawn to scale :AG WWW1.014. iftliSTIROMMO CONTkJICTO�s1NFOR` ITe„N ` ' '- and includes dimensions AGENT NAME CONTRACTOR NAME 77 A v/1 Ale N.02 t(JcJ HE Not I C{1I LC C. fI Site Plan including location AGENT ADDRESS CONTRACTOR ADDRESS of well/septic cAi'i E --c) 6717 SE 7e oc.a ,D. (City,State,Zip) (City,State,Zip) n Setbacks • /;'),40/S0 it-) bar •5./ 7)9 PHONE PHONE n Site Plan approval from /1 60� - ya - Slb - applicable township. E-MAILADDRESS E-MAILADDRESS . • It MAt/ii e 146Alost la/Z.CC, CAI". I I Floor plans to scale PR iotri yuce TIONI otijt ott_ONrr s'ei,/lacesseane.co,dawe= us/)v 1---- "`" PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: I Elevation of property PARCEL 1111 NUM ER 6?O''/'3 0 a dyp2 frontage drawn to scale. TOWNSHIP: SECTION: et/dDCETOiti 1/4: 1 Y4: O Driveway permits ADDRESS: (state, county,town) 78' 19 SCiAvvr E&f/ELa Die/i/E/ n Sanitary permits CSM: _ LOT #SUBDIVISION BLOCK/LOT 3� /N��r er. (public, private) PROPOSED-_PROJECT INFORMATION- a. y ,_. _ a r _ - f SY E. REiitE PROJECT DESCRIPTION: _- - Y SER.I4Ai 'corm., w rr t OECD 4&d✓e 0�aJ,....-:'-_,',W,7 0 roC - , , • nThis project is a new building or-structure. t �- err-4ei E s This project is an addition/alteration to an existing building or structure. _� , =>�'=� SANITARY SERVICE: PERMIT NUMBER: ,-9akess v T EWER _ EPT1C - i k. e 11v i_ ''_.4P=r HEIGHT IN FEET: • // NUMBER OOF STORIES: (Not including basement) -' �' ? ho atd- tac �f AREA TO NEAREST SQUARE FOOT =;,—, . - (Outside dimensions including unfinished area, attached garages and above grade decks or porches) , c. BASEMENT 1ST FLOOR: ' i* - -_ Q. SF 6SO S- ,, TOTAL SQUARE FOOTAGE: j - CS . 4_ bad . ' T 2ND FLOOR: 3RD FLOOR: - t ' _m v e a erg. ,-..-_,,1-1:- - • ESTIMATED CONSTRUCTION COST � Gd _ e - e e e (Please round to nearest dollar) ♦ "� "� �J/ �� 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? OYes-' ®No.• [Don't-know 2. Is there a wetland or floodplain on or near the property? []Yes 2No .ODon't know . 3. Have you talked with the township about your project and are they in agreement'? ®Yes ONo. . . - 4. Has there been a zoning permit issued for this property in the past 5 years'? Oyes • , No - 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none) 6. Is a location survey required? (see reverse) Oyes �No . ODon't know • 7. Is this to correct a violation? OYes [�No APPLICATION MUST BE SIGNED • - • (Continue on Back) —► -4 -4- 545-112(4IOB)