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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 /> Gary and Lauri Mill <br /> 0 Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1453 Pleasant Hill Rd Stoughton,WI Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (920)691-2824 gmill @topcon.com D Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cleary Building Corp 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Verona,WI <br /> PHONE PHONE 0 Site Plan approval from <br /> (608) 379-0132 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tleeser @clearybuilding.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: D Elevation of property <br /> DPARCEL 026/0511-031-9701-4 A-2 20.40 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Dunkirk 3 +/4: SE W/4%: NE ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 1453 Pleasant Hill Rd <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> Metes and Bounds <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: l',4.-OS o f <br /> 30x64 Storage shed �q Z o � <br /> 7"-ZA ❑ Zoning District <br /> . Eg This project is a new building or structure. <br /> ❑ Permitted Use? <br /> OThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER r)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 20.9 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: 1---, ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 2,400.0 <br /> /J ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) "+ "' -♦ ♦ -'� $ 80,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Efres ✓DNo DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Dyes Bo DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? DYes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes jlo <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) Dyes OW DDon't know <br /> 7. Is this to correct a violation? Dyes OW <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) • ■ -i <br /> 545-112(4/08) <br />