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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> J. Vern & Kallie Stenman <br /> 7,...oting Status; CUP; <br /> /OWNER ADDRESS (Number,Street,City,State,Zip) eed Restriction; CSM <br /> U 1417 Morrison Street, Madison, WI 53703 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)575-4267 vern @mallardsbaseball.com <br /> 12 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION y arfd includes dimensions <br /> AGENT NAME CONTRACTOR NAME v <br /> Dick Vock MODS International <br /> MI Site an uding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of we ptic <br /> 5523 Integrity Way 5523 Integrity Way <br /> (City,State,Zip) (City,State,Zip) 0 Set ks <br /> _Appleton,WI 54913 Appleton, WI 54913 <br /> V PHONE PHONE Site Plan approval from ISI <br /> 314 406-4350 (920) \applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dvock @modsinternational.com dlarson @modsinternational.com MI F\15yariplans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elev n of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p P rty <br /> El PARCEL 028/0610-133-8560-4 R-3 4.00 frafitage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Dunn 13 %: NW .1/4%: SW IN Drive permits <br /> ( e,county,town) <br /> ADDRESS: 3363 Fish Camp Road, McFarland, WI 53558 <br /> ISCSM: •' SUBDIVISION BLOCK/LOT <br /> p ry permits <br /> t\ '� Ic, rivate) <br /> t <br /> PROPOSED PROJECT INFORMATION : STAFF REVIEW <br /> PROJECT DESCRIPTION: ° ^ 1x; ' <br /> Two Story Single Family Home o -District <br /> �i - ter`= o -a, ,a <br /> This project is a new building or structure. � Iittea use7N <br /> El This project is an addition/alteration to an existing building or structure. ,4 <br /> SANITARY SERVICE: PERMIT NUMBER: +'Ru�Ad r ss ;_ <br /> EWER E)EPTIC i_1 -, fin ': <br /> HEIGHT IN FEET NUMBER OF ST RIES: (Not including basement) j i, <br /> V� .314 . S 2.0 etia "•, •••pa . <br /> AREA TO NEAREST SQUARE FOOT: Shorela' a �a nt) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) , <br /> BASEMENT: 1ST FLOOR: — '' �rosiol�i`Ontroi permit <br /> 0.0 2,731.0 4, TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, 1/4.1()(C, <br /> filling/access) L/ <br /> 2ND FLOOR: 1,598.0 3RD FLOOR: / 4,329.0 "R=�,,�--++ re <br /> eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: 422,500.00 and available options. <br /> (Please round to nearest dollar <br /> /� <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes 'lo ['Don't know/ <br /> 2. Is there a wetland or floodplain on or near the property? Q✓Yes alo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? jYes ['No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Yes ✓:lo <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 ONo ['Don't know <br /> 7. Is this to correct a violation? ['Yes t/No <br /> 1-4OO ' D1114 t11...L.NINIG\\ APPLICATION MUSTBFSIGNED <br /> 545-112 taioe> (Continue on Back) ♦ –• –► <br />