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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Matthew & Kristine Killerlain ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street.City.State.Zip) Deed Restriction;CSM <br /> 268 County Hwy DD,Belleville WI 53508 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)712-0613 killerlainfamily©gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION (CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Matthew Killerlain Meigs Inc-Dave Budden ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 268 County Hwy DD P.O.Box 412,1527 Hwy 14 <br /> (City.State.Zip) (City.State,Zip) ❑Setbacks <br /> Belleville WI 53508 Black Earth,WI 53515 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 712-0613 (608) 767-2729 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> killerlainfamily@gmail.com dave @meigsbuilds.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 040/0508-362-8845-0 RH-1 2.04 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Montrose 36 1/4: NW 1/41/4. NW ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 268 County Hwy DD, Belleville WI 53508 <br /> CSM LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 13,219 1 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 30'x 40'Storage Building ❑ Zoning District <br /> This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER [)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 15.6 1.0 ❑ wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErOSiOnCOntrOl permit <br /> BASEMENT 1ST FLOOR: <br /> 1,200.0 1♦ TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 1,200.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST ♦ -► ♦ i and available options. <br /> (Please round to nearest dollar) $ 18,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ✓No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o �on't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes ❑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 ao ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes 0No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4'08) <br /> (Continue on Back) —► —.• --e• <br />