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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CU •TOMER TO PROVIDE <br /> OWNER NAME <br /> Nate Snyder <br /> OWNER ADDRESS (Number,Street,City,State,Zip) FA Zoning Status; CUP; <br /> 320 Forreston Dr Cottage Grove WI 53527 Deed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)839-0392 Office@snyderxp.com El Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Nate Snyder ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> PHONE PHONE ❑Site Plan oval from <br /> pplic a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) evation of property <br /> rty PARENT PARCELNUUMBE QURRENTZONING: ACREAGE �Ei �,1 ., �O 1,V 0 , \1 14 NUMBER <br /> rontage drawn to scale. <br /> TOWNSHIP: <br /> Co i /rr,.e . C rSECT ION'y� <br /> c' //t--e_ `� 14: 1/4► % : N iveway permits <br /> ADDRESS: state,county,town) <br /> al yG' 1--( Pe Pd• Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT (p,•Sanitary <br /> private) <br /> PROPOSED PROJECT INFORMATION '' z <br /> PROJECT DESCRIPTION: '- <br /> Build Duplex R <br /> . 4 This project is a new building or structure. 10 Permthed Vse7 <br /> El This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> r)EWER JEPTIC 1 3,201,600,070 <br /> HEIGHT FEET), NUMBER OF STORIES: (Not including basement) <br /> (5 2.0 *t <br /> t .,;r ,#s'..,,` <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) , Eiiiso 3aal {o <br /> BASEMENT: 1ST FLOOR: TOTAL SQUARE FOOTAGE: <br /> o.o 2ND FLT 9IR 3RD FLOOR: <br /> q' ' I E 1 C 0 , <br /> ESTIMATED CONSTRUCTION COST: �tiva� ns. <br /> (Please round to nearest dollar) -+ -♦ ♦ —, "♦ $ Sig- (j(�' O <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [DYes JVo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ['Yes o ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ['Yes Lo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes alo <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 ❑No <br /> l l a APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545112(4/08) / ' <br />