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ZONING PERMIT APPLICATION www.countyofdane.com 1 SUPPLEMENT re•wsh-App <br /> I 1 <br /> _PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> `,■WNER NAME <br /> i Roy Kauper <br /> I [+Zoning Status;CUP; <br /> `-.v.State.Z.p; Deed Restriction;CSM <br /> 800 County Highway A Variance # ) <br /> I nUMt P-)NE 1 CELL PHONE iE-MAIL ADDRESS It <br /> i (608)501-8815 1 (608)501-8815 i ^ Site Plan drawn to scale <br /> INFORMATION (CONTRACTOR INFORMATION and includes dimensions <br /> \'RACTOR NAME <br /> I [ Site Plan including location <br /> i AG �_ SS I CONTRACTOR ADDRESS of well/septic <br /> --,�v,o _. I'cy State.z;.", iEletbacks <br /> i I <br /> I -- ! _ e Plan approval s-cm <br /> ( <br /> i I applicable township. <br /> IC IV,.■L M:JJRE S IC-MAIL ALSLSS ESL-, <br /> i 1 Floor plans to scaie <br /> -PROPERTY/LOCATION INFORMATION (bttpll/sccessdsnaco.dsewwLus/) dElevation of property <br /> 'FARCE M <br /> .NL BER ^"RRENT ZON'NG ACREAGE. <br /> I Q PARCH i 016/0612-333-9501-7 i A-1(EX) 34.78 frontage drawn to scale. <br /> i ivUMBth. 1 I <br /> i,Li e..Ji,,r ,L.„:.JVii. <br /> I TO6NR12E/TOWN OF CHRISTIANA i 33 %: SE / 4: SW riveway permits <br /> state, County,town <br /> iADDRE <br /> I 800 County Highway A, Edgerton, WI. <br /> Sanitary permits <br /> i- . i s I_ (public, private) <br /> PROPOSED PROJECT INFORMATION <br /> PPOJECT DESCRIPTION r 1 <br /> I GARAGE � x,30 I -- -: ' t r n�t- <br /> i <br /> . i IThis project is a new building or structure. <br /> eml'ittec!Used. <br /> 1 his project is an addition/alteration to an existing building or structure. _,`y}` 4 <br /> 1,—. /An 1 ...-rt VI,.,"_- I PERM■I N...MECR. 8.:f f.'tul {Mdresss <br /> I PFWER <br /> (neWieXlStin <br /> Iuc_'r;L T iN CEEr ylEPTIC I NUMBER OF:?C1R,cc SCiu� base—en?) <br /> I t �;r�^ <br /> - / fr J 1lllettancitF#oodplatnf <br /> I . . ttore#andattieltmertj <br /> AREA TO NEAREST SQUARE FOOT: <br /> i(Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> �r �ooR Emsit: onto}pern <br /> i +...: <br /> tEs>tia1_�el f-N 1 -- ---- + TOTAL SQUARE FOOTAGE: ,i ::109.peS;disturbance <br /> i.,._. , � ..#iingfaccess) <br /> i <br /> I . euieW: .bcab.0 0Wejr <br /> i ESTiNiATEDCONSTRUCTION COST: �a1)0-aVaifat)teOptloris ?' <. <br /> ( ki-iease round to nearest dollar) -+ -+ ♦ -► ♦ -► I $ 18,000.00 <br /> i. The property is within 300 feet of a stream or 1000 feet from a pond or lake? DYes ao ✓ D'on't know <br /> 2. is there a wetland or floodplain on or near the property? ( Yes o on't know <br /> ............... <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? DYes ,, No <br /> 5. Is this project associated with a rezone/CUP/variance(petitiorJappeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Dyes ONo [✓]Don't know <br /> 7 Is this to correct a violation? DYes ✓QNo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -I. -+ '♦ <br /> :.kla I,2(4,x) <br />