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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Scott and Sarah Mooney ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 8318 Blackwolf Dr Madison,WI 53717 Variance(# 101 83 ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)206-1669 (608)206-1669 snerz @charter.net ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Chris Cook Chris Cook Homes LLC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1235 Hanover Tr PO Box 335 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Waunakee,WI 53597 Waunakee,WI 53597 <br /> PHONE PHONE El Site Plan approval from <br /> (608) 577-1945 (608) 577-1945 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> chris @chriscookhomes.com chris @chriscookhomes.com El Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑PARCEL 022/0908-351-8500-1 1.58 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP:TOWNSHIP: SECTION: <br /> Dane 35 /4: nw l/41/a: ne ❑ Driveway permits <br /> ADDRESS: (state,county,town) <br /> (D(o 32 I-1 _11-0 tom. ❑Sanitary permits <br /> CSM: 2,133 LOT 3 SUBDIVISION BLOCK/LOT (public, ) <br /> ublic, private) <br /> PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Build a single family home ❑ Zoning District <br /> . o This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER [EPTIC 13,201,600,318 (new/existing) <br /> HEIGHT IN FEET: I N NUMBER OF STORIES: (Not including basement) <br /> ICI _ Cs 1.0 ❑ Wetland/F000dplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ ErosionControl permit <br /> BASEMENT 1ST FLOOR: TOTAL SQUARE FOOTAGE: (slopes,disturbance, <br /> 2 003.0 3 804.0 filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 5,807.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ - ♦ ♦ ♦ ♦ and available options. <br /> (Please round to nearest dollar) $ 472,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yeslo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? EYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes 0No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) ve blank if none) <br /> 6. Is a location survey required? (see reverse) tai-s Etslo ❑Don't know <br /> 7. Is this to correct a violation? / es ❑No <br /> APPLICATION MUST BE SIGNED <br /> 54 5-112(aios) (Continue on Back) <br />