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DANE COUNTY ZONING DIVISION RECEIVED <br /> CITY COUNTY BUILDING, PM 116 U0- i t.'': <br /> 210 MARTIN LUTHER KING, JR. BLVD. <br /> MADISON, WISCONSIN 53703-3342 NOV 1 2 2008 <br /> • ` <br /> 1639; " <br /> PHONE 266-4266 FAX 267-1540 g �� <br /> www.countyofdane.com/zoning NING b DEVELOPMENT <br /> � <br /> ZONING PERMItEC IST <br /> PLEASE FILL IN AS MUCH INFORMATION AS POSSIBLE. <br /> 1. LANDOWNER: Eugene Matusevich AGENT: Chris Hooker, Quam Engineering <br /> ADDRESS: 1137 Highland Lane ADDRESS: 4893 Larson Beach Road <br /> Glenview, IL 60025 McFarland, WI 53558 <br /> PHONE: (229) 5-22- 22 - o2 PHONE: 608-838-7750 <br /> EMAIL: A64-77,5 5,9 ejif*2 ?Gs, EMAIL: hooker.chris@gmail.com <br /> 2. TYPE OF PROJECT: New Single Family Residence <br /> ESTIMATED ESTIMATED COST OF CONSTRUCTION: $ 'T Ci ( (Structure plus mechanicals) <br /> 3. ADDRESS OF PROJECT, IF KNOWN: 362 Lake Shore Drive, Edgerton, WI <br /> 4. LOCATION OF PROJECT: <br /> TOWNSHIP,SECTION,1/41/4 NW of the SE <br /> TAX PARCEL NUMBER 0512-254-2144-2 <br /> SUBDIVISION OR CSM#(Certified Survey Map),IF ANY: Edgerton Beach Park Block 1 <br /> LOT NUMBER,IF ANY: N1/2 Lot 13 & All of Lot 14 <br /> 6. ZONING DISTRICT: R-3 <br /> 7. SITE PLAN: *A site p/an must be drawn to scale showing the lot lines and lot dimensions, the locatior, <br /> and size of all existing and proposed buildings or additions and their distances from <br /> lot lines. If the lot is not served by public sewer, the location and size of the on-site <br /> septic system and the location of the well shall be shown on the plan. <br /> Example of a Site Plan on reverse. <br /> 8 FLOOR PLANS AND ELEVATION VIEWS (front, sides, rear): A copy will be kept in Zoning Division files. <br /> Examples of Floor Plans and Elevations attached. <br /> 9. PUBLIC SEWER OR PRIVATE SEPTIC SYSTEM? Public Sewer <br /> STATE SANITARY PERMIT NEEDED? Y �..J IF YES, PERMIT# <br /> APPROVAL FOR ADDING BEDROOM OR > 25% AREA NEEDED? Y / N IF YES, PROVIDED? Y / N <br /> 10. DRIVEWAY (or Culvert or Access) PERMIT NEEDED? Y i6 IF YES, PROVIDED? Y / N <br /> Many Towns require a Driveway Permit;County Highway Department or WDOTpermits may be required for <br /> driveways with access to a County, State or US Highway <br /> 11. SHORELAND?0/ N FLOODPLAIN?/ N WETLANDS Y N? <br /> 12. TOTAL AREA OF LAND DISTURBANCE (Square feet) 7,500 <br />