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• DANE C LINTY - ZONING PERMIT APPLICATION D-349 <br /> as iL <br /> 9-2,s' _ / - "e, r" / / r c V _ __: �i NUMBER ROAD TOWN lit 34 <br /> LOT BLK SUBDIVISION NAME OR C. S. M. BER C.U.P. # ZONE ' <br /> 1 <br /> c <br /> TYPE OF IMPROVEMENT PROPOSED USE <br /> New building <br /> c2,41, 001 One family bldg C J 013 Sery sta/garage <br /> [ ] Addition [ ] 002 Two family bldg C ] 014 Hospitals/institutions <br /> [ ] Alteration C ] 003 Three/four family bldg C ] 015 Office/professional <br /> C ] Repair/replacement C ] 004 Five/more family bldg C ] 016 Public works/utility <br /> [ ] Moving/relocation C ] 006 Transient hotel/motel C ] 017 Schools/educational <br /> TYPE OF FRAME C ] 008 Amusement/recreational C ] 018 Stores/mercantile <br /> C ] 009 Churches/religious [ ] 019 Other non-residential <br /> N. Wood frame C ] 010 Industrial bldg C ] 020 Tanks/towers <br /> [ ] Masonry (wall bearing) I ] 011 Parking garage C ] 021 Add/alt residential <br /> [ ] Structural steel [ ] 012 Residential garage I ] 022 Add/alt non-residential <br /> C ] Reinforced concrete PROPOSED USE (If non-residential, describe in detail) <br /> [ ] Other <br /> SEWAGE DISPOSAL <br /> C ] Public <br /> q>41 Private t // <br /> Permit # ,I, 4,ir l "C J S A / <br /> DIMENSIONS OWNER y7oq <br /> G ,6 ,` ,i/eal/4/ 0 ,0f, <br /> Long 0' Wide 3 3 //Iq // L4 <br /> te_A ; j rG .L. <br /> Stories / Feet /' <br /> / �` - / I e' k0 4 1 �rcl A a e <br /> Total floor area <br /> Total lot area CONTRACTOR fl(/2 PARKING SPACES (' /'-'0 i S r t;/ y-. 4 ; , <br /> Required The undersigned and the owner of this building agree to conform to <br /> Furnished all applicable ordinances of Dane County. <br /> SHORELAND/FLOOD PLAIN (_ `R.41- 1,!,_ 'v' <br /> Permit # Signature of eror\his agent Date <br /> VARIANCE INSPECTION RECORD /� <br /> Permit # Front yard Right yard Left yard Rear yard c� <br /> DWELLING UNITS (003-004) Date C2-7 7 ' By d1 V// Certificate issued 51-31-70 By ,? 2;k <br /> 1 br Notation <br /> 2 br Cheii7 / i' <br /> 3 br fSiT /7 ` ;2 I,.1e/ AP C. /7/- / `' G/Z%r ; <br /> Total flcijx, /L 'c i / A/fi Ili I!-01' i 1.1 ;F'/c// &'s•// b1-P1'r/ /?c? <br /> PERMIT # 25-6G 3 YEE 22 c212 VOUCHER OR RECEIPT # DATE -jl'2 tv <br /> COST OF BUILDING 7( 00O va Issued b ,. / <br /> y ird - d 4 i t. <br />