Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jack and Carole Jacoby <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 3315 River Birch Ln,Middleton,WI 53562 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)358-4506 caroleajacoby @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Hart DeNoble Builders Hart DeNoble Builders Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 7923 Airport Rd 7923 Airport Rd <br /> (City,State,Zip) (City.State,Zip) ❑Setbacks <br /> Middleton,WI,53562 Middleton,WI,53562 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 831-4422 (608) 831-4422 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> bnorth @denoblebuilders.com bnorth @denoblebuilders.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE. <br /> PARCEL <br /> NUMBER o o 35-4(204; •� <br /> o Res. /Q_( g frontage drawn to scale. <br /> TOWNSHIP: SECTION <br /> Springfield 1/<: '//: ❑Driveway permits <br /> ADDRESS ,, .. ee (state,county,town) <br /> Vv 1 I P YoS`C. C'k ❑Sanitary permits <br /> CSM LOT SUBDIVISION BLOCK/LOT <br /> Cherry Hill (public, private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION <br /> New Single Family Res. <br /> } <br /> . 12 This project is a new building or structure. <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER <br /> EWER JEPTIC <br /> HEIGHT IN FEET NUMBER OF STORIES (Not including basement) s. ;`" <br /> 26.0 2.0 k <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including nfinished area attached garage- and above grade decks or porches) , <br /> BASEMENT 1ST FLOOR <br /> 1 ,802.0 2,855.0 j TOTAL SQUARE FOOTAGE: <br /> 2ND FLOOR 3RD FLOOR <br /> 1 ,425.0 6,082.0 `/ <br /> ESTIMATED CONSTRUCTION COST: 52O OOO.00 � s f <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ , -,,.1%,,:.:,. "f ..,r „' q¥ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑No DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? fYes ❑No ❑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 ENo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -s -♦ <br /> 545-112(4i0e) <br />