Laserfiche WebLink
297 - <br /> 7-) Irl- Cc lie rrw . / VIVIArve, W (e)-eg = (A) 11187--A <br /> Awl ,,,,,r, et <br /> SUPPLEMENT to Web-hpp# <br /> 'ZOJING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION OFFICE USE ONLY <br /> OWNER NAME <br /> PD 514-1 14 coning District <br /> OWNER ADDRESS (Number,Street,City,State,Zip) \. - <br /> ISO9 1-40Pt.] tU... tP.' \10.00A, t►`' . 5 55B ❑ Permitted Use? <br /> PHONE E-MAIL DRESS L <br /> �0 0 S • 54S- ki 1 batrtoh c (4,US•t to •CD M ❑ Zoning Status; CUP; i <br /> AGENT.INFORMATION CONTRACTOR INFORMATION Deed Restriction;CSM <br /> AGENT NAME CONTRACTOR NAME Variance(# �,-, - ) <br /> tvtkk.. WO({LrrE - VestAw 51�r '15251 1--I- ; <br /> AGENT ADDRESS CONTRACTOR ADDRESS r <br /> ,..` 3�-, 61 G(e� R4P,IS �. LA/Site Plan drawn to scale <br /> "� and includes dimensions <br /> (City,State,Zip) (City,State,Zip) <br /> \ 4 t)L.6[DF)) W—+, 554::z Ste Plan including location- <br /> PHONE _ PHONE , epe.Z- o�O (42/4,31) <br /> of well/septic <br /> E-MAILADDRESS E-�MAIL`DDRESS 1 (�, <br /> tYAl �-@ �S(' SkING t S feDM Setbacks <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) to Plan approval from <br /> PARENT PARCEL UMBER: ZONING: ACREAGE: applicable township. <br /> ❑ NUMBER 0Z80610-611-214o-5 IirO29�JiF <br /> TOWNSHIP: SECTION: <br /> bu1J1■1 1 1/4: 1414: ❑ Rural Address <br /> (new/existing) <br /> ADDRESS: <br /> al 1 NFje Cep r o• t Mc p4 D) z-L, 53 <br /> ❑ Floor plans to scale <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 0L, t ❑ Elevation of property <br /> PROPOSED PROJECT INFORMATION frontage drawn to scale. <br /> PROJECT DESCRIPTION: BOitAi/II.A - - 1W0 r— y 1.V k MIL <br /> ROM . At,) GYASTUA ` TRUc.1vi MIL' $E VEMGLI'3 1)• U Driveway permits <br /> . XThis project is a new building or structure. (state,county,town) I) <br /> ❑This project is an addition/alteration to an existing building or structure. i'\ , M <br /> " -Sanitary permits <br /> SANITARY SERVICE: PERMIT NUMBER: t' {,t ■ <br /> SEWER ❑SEPTIC (public, private) tt# z <br /> HEIGHT IN FEET /_t NUMBER/O�FF STORIES: (Not including basement) 1�Wetland/Floodplain/ <br /> ANC) 2- 2 b Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) n,-ErosionControl permit <br /> BASEMENT: 2,1100 � 1ST FLOOR w 13n I 'tr , <br /> L G. TOTAL SQUARE FOOTAGE: ♦ (slopes,disturbances.. <br /> 2ND FLOOR: 3RD FLOOR: filling/access) -,C_. �i(t^ <br /> 1 X33 96 5,15°l.d , <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -► -► ♦ - ♦ ♦ $ 1�'-12_,090 and available options. <br /> (Please round to nearest dollar) 1 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lak ? Yes ❑No ❑Don't know <br /> k2. There is a wetland or floodplain on or near the property?.. .. . .........Aga ...tifYes ❑No ❑Don't know <br /> 3. Have you talked with the township about your project? Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes $No <br /> 5. This project is associated with a rezo /C P/vari nce(petition/appeal# _) (leave blank if none) <br /> 6. Is a location survey required? .L.( it Si A , )4Yes Li No <br /> 7. Is this correcting a violation? ❑Yes 'No <br /> 353E APPLICATION MUST BE SIGNED <br /> sas-112 woad <br /> �J ta.1GC (Continue on Back) <br /> L . <br /> 4 okytktiTRA <br /> a vim• 8, Zcr� NA e, . N0+-e o n per 11/1 ( f <br />