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DCPZP-2016-00599
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DCPZP-2016-00599
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9/26/2016 3:55:13 PM
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9/26/2016 10:18:31 AM
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Zoning Permits
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DCPZP-2016-00599
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, <br /> 1ls` /c <br /> DANE COUNTY ZONING DIVISION . <br /> crTY COUNTY BUILDING, RH 116 • <br /> 210 MARTIN LUTHER KING,It BLVD. ,. R <br /> MADISON,WISCONSIN 53703.3342 <br /> fit yt� <br /> PHONE 266-4266 FAX 267-1540 <br /> www.countyafdane.comfzoning <br /> ZONING PERMIT CHECKLIST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> • <br /> 1. LANDOWNER: 17�,��-`+�iX C111 O i /1-1--(— AGENT: <br /> ADDRESS: .2 O 0100A.ititdo 2 p.(L. r ADDRESS: <br /> PHONE: n/• °� 3 r v/�9> PHONE: <br /> EMAIL: EMAIL: <br /> Z. TYPE OF PROTECT: -- V.1, <br /> 14 <br /> ESTIMATED COST OF CONSTRUCTION: $ 13 \7 O O sStrueture plus mechonira/s) <br /> } f)(L(s, <br /> 3. ADDRESS OF PROJECT, IF KNOWN: ?/6,-,A ` <br /> ' <br /> • LOCATION OF PROJECT: <br /> +1 <br /> TOWNSHIP,SECTION,1/9 1/4 {"1 w <br /> TAX PARCEL NUMBER <br /> SUBDIVISION OR CSM#(Certified Survey Map),IF ANY: S Pk\1(C <br /> LOT NUMBER,IF ANY: r <br /> f--ZONING DISiRFI7:— _ — <br /> 7, SITE PLAN: '"4 site plan must be drawn to scale showing the lot lines and lot dimensions,the location <br /> and size of all existing and proposed buildings or additions and their distances from <br /> lot lines. If the lot is not served by public sewer, the location and size of the on-site <br /> septic system and the location of the well shall be shown on the plan. • <br /> Example of o Site Plan an reverse. <br /> $ FLOOR PLANS AND ELEVATION VIEWS (front, sides, rear): A copy wil/be kept in Zoning Division files. <br /> Exairp/ex of Floor Plans and flevatians attached. <br /> 9. PUBLIC SEWER OR PRIVATE SEPTIC SYSTEM? LA4-- <br /> STATE SANITARY PERMIT NEEDED? C'/N IF YES, PERMIT# 13 --{) <br /> APPROVAL FOR ADDING BEDROOM OR > 25%AREA NEEDED? Y/f) IF YES, PROVIDED? Y( <br /> 10. DRIVEWAY(or Culvert or Access)PERMIT NEEDED? Y L-� IF YES, PROVIDED? Y / <br /> Many Towns require a Driveway Permit;County Highway Department or WDOT permits may be required far <br /> driveways with access to a County,State or US Highway <br /> 11. SHORELAND? Y 11 N 1 FLOODPLAIN? Y (N J WETLANDS Y/ <br /> 12. TOTAL AREA OF LAND DISTURBANCE(Square fest) <br /> r <br />
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