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t?)8 - <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Patrick R and Kelly A McGrath ❑Zoning St us; P; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Rest - ion;CSM <br /> 2087 Frawley.Drive, Sun Prairie, WI 53590 s, Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)692-4716 (608)692-4716- ,kelly.mcgrath4 @gmail.com ❑Sitp Plan drawn to s <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes di sions <br /> AGENT NAME CONTRACTOR NAME <br /> Keuler Construction, Inc. Keuler Construction, Inc. ❑Site P a Including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of wel septic <br /> 8308 State Road 19 8308 State Road 19 <br /> (City,State,Zip) (City,State,Zip) ❑Setbc s <br /> Cross Plains,WI 53528 Cross Plains, WI 53528 VVV <br /> ❑Site Pla val from <br /> PHONE (608) 798-1771 PHONE (608) 798-1771 applica etownship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> keulerconstruction @hotmail.com keulerconstruction @hotmail.com ❑Floor plans t ale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation o p erty <br /> ❑ <br /> PARENT PARCEL NUMBER: CURRENT J• I ACREAGE: C7 <br /> PARCEL C • 5 frontage dr n to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Springfield 31 1,4 1/41/4: ❑ Drivew per its <br /> (state,c y,town) <br /> ADDRESS: �J, ;� <br /> 7013 .�/hU 2 ?oil; Iry - ❑Sanitary permits �,(� <br /> CSM: LOT �� SUBDIVISION BLOCK/LOT (public,private) �' ' v r <br /> Autumn Pond <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Construct single family home ❑ Zoning i Ict <br /> . 12 This project is a new building or structure. ❑ Permitt '{IJse? <br /> ['This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ R Address <br /> EWER [EPTIC 13,201 ,600,322 (r(',y'existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> U 1 1)" .2".„.2......„ 2 0 ❑ Wetland/Floodplain/ t ,op Q <br /> Shoreland (attachment) `-!.„) <br /> AR O NEAREST SQUARE FOOT <br /> (Outside dimensions including unfinished area,attached garages and,a�bove grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: / 1ST FLOW'_ <br /> (G VVV o 3�) TOTAL SQUARE FOOTAGE: + (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: ,/� / '^ <br /> 1 � uQ O r ' La, 7' 7 v ❑ Review LOCH tit 4*urvey <br /> ESTIMATED CONSTRUCTION COST: d� ! _ / t [ l_ -\00 and availa•'e ;•r,•ns. <br /> (Please round to nearest dollar) ♦ -► ♦ -► ♦ -► $ 1.P—r Tj OCCJ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ✓❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres ✓N° ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓❑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) [Yes isiNo ❑Don't know <br /> 7. Is this to correct a violation? [Yes 111No <br /> A ,� ` � 1 , � � APPLICATION(Continue Back) - SIGNED <br /> (t�f►'�� f�J Al �•-�� (Continue on Back) <br /> 545-112(4/08) <br />