Laserfiche WebLink
DANE COUNTY <br /> APPLICATION FOR PERMIT TO DEVELOP IN A FLOOD PLAIN OR WETLAND PERMIT NO. FP S 2-7C— <br /> The undersigned hereby makes application for a permit to develop in a flood plain. The work <br /> to be performed, including flood protection works, is as described below and in attachments <br /> hereto. The undersigned agrees that all such work shall be done in accordance with the req- <br /> uirements of the Dane County Flood Plain Zoning Ordinance and with all other applicable <br /> County Ordinances and the laws and regulations of the State of Wisconsin. <br /> LOCATION: 1 <br /> 6 / ..1/ L-:-- rc 41-Y I,Ii/ J(,1 I`,,> c s °` <br /> Number Road Town ec 1/4 1/4 <br /> Lot Block Subdivision or C.S.M. Number Zone <br /> PROPOSED WORK: BUILDING: FLOOD DISTRICT: AREA: <br /> Subdivision New General FP x <br /> Filling X Addition Regional FF Square feet 1O oO0e't <br /> Grading X Alteration X Regional FW RFE USGS <br /> Mineral removal Moving X Top of fill USGS <br /> Dredging Z.P.# FIRM ZONE Cost <br /> Owner p Gj CONTRACTOR/BUILDER <br /> //t/t2N/ D C1'71: (?//11111-1.1 Z-"--/f/ , <br /> / on n c Q'fir'v j-- OLD 1/OC 1., /ft-- = box rWOc/ICJ <br /> i vii /+7 <br /> Signed: , � 7711, a/le--A_ (Owner/Agent) Date /oh <br /> Permit iss ed 10/2-8f p8 Permit denied Reason <br /> 1 <br /> Fee $ i Z -O0 By $/%V � Date /O Zb`U, <br /> Inspection record: <br /> By: Date C of C issued By: <br /> Plans prepared by Date <br /> Land Surveyor/Engineer/Architect <br /> Sent to DNR District Main Office By <br /> Other information <br /> 545-44(12/78) <br />