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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 /> Adam & Jennifer Wendorf <br /> Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2817 Spring Hill Dr. Stoughton, WI 53589 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)873-0840 (608)279-1211 adam @wendorfconstruction.com Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Wendorf Construction and Remodeling 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2817 Spring Hill Dr <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Stoughton, WI 53589 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 279-1211 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> adam @wendorfconstruction.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: El <br /> ❑PARCEL 046/0611-271-8215-3 Al EX-RH2 4.58 frontage drawn to scale. <br /> NUMBER ( ) <br /> TOWNSHIP: SECTION: <br /> Town of Pleasant Springs 27 -1/4: T6N 1/4+/: RI I E ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> ❑Sanitary permits <br /> CSM: 8,082 LOT 1 SUBDIVISION BLOCK/LOT (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Outbuilding ❑ Zoning District <br /> 51 This project is a new building or structure. <br /> ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER PEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 21.1 1.0 ❑ Wetland/F000dplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,att croages and above grade decks or porches) <br /> BASEMENT: 1STFLOOR ❑ ErosionContr0l permit <br /> j TOTAL SQUARE F TALE: , (slopes,disturbance, <br /> 3 2 filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> —3,200.0 • <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ tic, 00 and available options. <br /> (Please round to nearest dollar) / D �!, DV <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes ao ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres ao ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ElYes EIVo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes lalo <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) [Iles EINo ['Don't know <br /> 7. Is this to correct a violation? QYes ✓IVo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/18) <br /> (Continue on Back) ■ -► -+ <br />