Laserfiche WebLink
� Lj <br /> ZONING PERMIT APPLICATION www.countyo d ne.�com r 'CJ SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> 2-et- Bc\\0. ❑Zoning Sta us;CU <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Rest cti ;CSM <br /> 2408 Arr. ec'S-E Ra, M;v� &\e.�ah �W r S. 5(:)-2- Variance( ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> G 0$-35$-0`122 ❑Site Plan dra t le <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes . ensions <br /> AGENT NAME CONTRACTOR NAME <br /> r-A.,ooeN C.:.-0,5 e ❑Site Pip jpitluding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well ptic <br /> (okSo CzAk,,,,� Ave, 430\ <br /> (City,State,Zip) (City,State,Zip) ❑Se a S <br /> NV, &\c_A-oh ,WI/ 535(.2 <br /> PHONE PHONE ❑Site Plan ;•• from <br /> 60?,--y-I 1 - 0033 applica• - to <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> bcGS`,0 cQ• rm.:,\,c.o M ❑Floor plays t6'scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevatio o roperty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL o 38 1O1 O8 -30‘-$cS0-0 A- ` 2,000 frontage raven to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION <br /> Town oc M; \eiroh +/,; +/4+/4: 0 Driveway r t <br /> ADDRESS: (state,CO n t Y 1) <br /> 7/0(aS W M,,.,er.,`\ Pc.>;w k- R� -,c,. <br /> ❑Sanitary •- its <br /> CSM: LOT SUBDIVISION BLOCK/LOT (publi/ • ) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: <br /> G0,rde∎-, Shed 0 Zonii i ` <br /> . ''This project is a new building or structure. Li Penn' Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 0 m/Ru Address <br /> EWER 1)EPTIC (newIex <br /> HEIGHT IN FEET: ^- / NUMBER OF STORIES: (Not including basement) ❑ S <br /> Vll �t <br /> �Q4 8 B ° yes <br /> AREA TO NEAREST SQUARE FOOT: / <br /> (Outside dimension ' uding unfinished area,attached garages and above grade decks or porches) 0 EroS10ncon �. !g-rm <br /> BASEMENT: 1ST FLOOR: <br /> rL i(o c42 4, TOTAL SQUARE FOOTAGE: ,, (s.oa a " f'. - , <br /> 2ND FLOOR: 3RD FLOOR. 2-AG - '� <br /> 2-AG c42 <br /> Q Review Lam►Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ $ 2,o, \ and available options. <br /> (Please round to nearest dollar) �P <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes to [ Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o EIP on't know <br /> 3. Have you talked with the township about your project and are they in agreement? EiYes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes o <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 CI o ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes Q. O <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) —► -. —► <br />