Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Sa c . k 1.'/, K CUP; /� <br /> ;�� Zoning Status; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> 5-88K7.0 geed Restriction; CSM <br /> w.,� I� G� l�t��'l/� �..Z S-3�S o 8 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> ✓ (jo48.-;38-8)51 Sc.. , 1;,, _ „ Sbc. , obe, .ne'F A Site Plan drawn to scale <br /> AGENT INFORMATION (CONTRACTOR INFORMATION and includes dimensions /D <br /> AGENT NAME CONTRACTOR NAME <br /> : S WO 44C el_ Nv1 cer Co v. rc..ci rt S. c ing locatio <br /> AGENT ADDRESS CONTRACTOR ADDRESS f well/septic <br /> /b(l W. C,/.k.c.k sf . int( Ul. C 1,a.-tl. .4f <br /> (City,State,Zip) (City,State,Zip) 1 Setbacks 6 <br /> 1.22A.((?,0J1/G, u,)T' 5--3Sa 8 ttlet,'1I4 (.,)2 5 3sd 8 <br /> PHONE PHONE Site Plan approval from J <br /> bog - 5-13 — (.( 3U o (9 0 8 - - 3-Ll 3o a applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> rIv l- -,nc,r,54 AKA C% - c .,,co....N. i 44.G ■C019*-54r`cd-a z jut <br /> o,c•r.1 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:llaccessdane.co.dane.wi.us/) 306 <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: levation of property <br /> D PN OS —233 ' 0/-0 R I-1—Z 5., I I Z. rontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> -1-05-A)ROS E 2.3 1/<: sE 1/1/4: S U t1 Driveway perb <br /> ADDRESS (state,county <br /> 58 $ 14.---y R R . &c 1t0,*l(,_ WT. S g .4 Sanitaryp is <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanit rc <br /> 10309 1 <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> c. Zy ,t'3p 4,j C,6.r0c,._ 0 L I v e_51-0c-k---pi Zoning District il '' <br /> 'Ef, <br /> . This project is a new building or structure. (,Cck.^S Z , U v- I A.S/' (c24e-e( <br /> Permitted Use? �� 3 <br /> This project is an addition/alteration to an existing building or structure. ,, �'/ec�t 6 ecA G 4 r <br /> SANITARY SERVICE: PERMIT NUMBER: 4 Rural A.;ess <br /> EWER EPTIC (new` M <br /> HEIGHT IN FEET: j / NUMBER OF STORIES: (Not including basement) i <br /> Z +• / �( i "l� 0.�4,r_ S c�c_ _ .odplain/ . .�61'© <br /> �` orelan. attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) �r <br /> BASEMENT: 1ST FLOOR: rOSIOnCOntrOl permit q.. <br /> a <br /> —� 7l. 4 TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, t <br /> filling/access) to/r <br /> 2ND FLOOR: 3RD FLOOR: ` <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ / �� and available options. N/b- <br /> Please round to nearest dollar) (2 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Elves kj/ o ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? MI es ■47/ o ODon't know <br /> 3. Have you talked with the township about your project and are they in agreement? ►r►es III o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Oyes EVo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? -- reverse .. QYes rilNo ODon't know <br /> 7. Is this to correct a violation? Oyes a"lo <br /> / 7'9, 00 - APPLICATION MUST BE SIGNED <br /> (Continue on Back) -i -+ -► <br /> 545-112(4/08) <br />