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/0 Cafior■ SU-Ail)--e 43) Cliff&Janice Lawton �`/ ' <br /> 7347 Tetiva Rd. <br /> Sauk City,WI 53583 .Z.,... )lik <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION - CUSTOMER TO PROVIDE <br /> OWNER NAMEe l �' <br /> /i�LJ-Y-k >i'-5-441 AI c.e. L a.LJ t--)v\. A� • ing Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State, p) •. <br /> 3 L/ 7 7 ,vQ ,Z Deed Restriction;CSM <br /> ? / Variance(# ) <br /> H ME PHONE CELL PHONE E-MAIL ADDRESS Q <br /> '6�6 %5z 1 �1 --S 7g • 1 1■ 5�t�e Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and inclu limensions <br /> AGENT NAME _ CONTRACTOR NAME Dcq�t� ' ' <br /> 1 ADDRESS 16.).- ., rJ24-7 CONTRACTORADDR��/ GOB,•4 • tYe Plan including location <br /> tta 6� / K i e' C4 neAzt k___.- of well/septic <br /> (city,state,Zip) (City,State,Zip) v ❑ Setbacks <br /> /11 aLz.a wld.Y.t E z-Lie-S 35e3 <br /> PHONE PHONE ❑ Site Plan approval from <br /> 995- 142-2, f applicable township: r`,, er <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> t Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) .`�"Jr <br /> PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property V.� ,\\ <br /> ARCEL (� p r / frontage drawn to scale. / ` <br /> NUMBER d• )(1•�.�`JlrY JI�/�' EL0�07 / f <br /> TOWNSHIP: /'1I / I N ❑ Driveway permits AD FOA <br /> S: / (state,county,town) iv it- <br /> 23 7 `7; A.h . o�'6 �/�2 a•. <br /> C LOT SUBDIVISION / BLOCK/LOT ❑ Sanitary permits <br /> 93 •/�� (public,private)W' <br /> PROPOSED PROJECT INFORMATION ' "r:� TA 1Z VIEW <br /> PROJECT DESCRIPTION: / <br /> ww❑This project is a new building or structure. _ r <br /> LrJ This project is an addition/alteration to an existing building or structure. ` .. 7 <br /> SANITARY SERVICE: A/A PERMIT NUMBER: <br /> ❑SEWER U SEPTIC - rr <br /> HEIGHT IN FEET 0 1 NUMBER OF STORIES: (Not including basement) & azg Wit, _' <br /> r <br /> AREA TO NEAREST SQUARE FOOT: - � <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) - - <br /> BASEMENT: � :414:;V:�� �� �� � ��� � :�,. <br /> 4, TOTAL SQUARE FOOTAGE: ,- : �1 � ti <br /> 2ND FLOOR: 3RD FLOOR: s ® ., - <br /> S A 4 <br /> ° �r <br /> ESTIMATED CONSTRUCTION COST: ' -� , <br /> (Please round to nearest dollar) ♦ -► --i• -► --► <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes C No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? �❑Yes ago ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? L7 Yes LI No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes 0 1``+ <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 ❑No ❑Don't knew <br /> 7. Is this to correct a violation? ❑Yes I I <br /> LJ /� APPLICATION MUST BE SIGNED g <br /> 545-112(4/08) `►4 v k (Continue on Back) -► -► -► <br /> l # <br />