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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 /> Guldsteen Farms Trust <br /> El Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2255 Tower Dr.Stoughton WI 53589 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)395-4392 AJ@ArnettHomes.com 151 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Arnett Homes LLC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2255 Tower Dr <br /> (City,State,Zip) (City,State,Zip) IN Setbacks <br /> Stoughton WI <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 395-4392 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> AJ @ArnettHomes.com 151 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 0611-231-9175-0 A-2(4)Ag Distric frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Pleasant Springs 23 1/4: NE 1/41/4. sw ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2255 Tower DR Stoughton WI <br /> CSM: 13 189 LOT 1 SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 12x20 covered deck on North side of building with stairs ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> IN This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> FIEWER [EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 18.0 1.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionControl permit <br /> 250.0 j TOTAL SQUARE FOOTAGE: 1 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 250.0 <br /> LI Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ and available options. <br /> (Please round to nearest dollar) .+ $ 4,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ✓INo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes 'lo ['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? QYes ❑No <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) Ekes �Vo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes jlo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545-112(4/08) <br />