Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION OFFICE USE°ONLY <br /> OWNER NAME <br /> 3/2.r/r,v -1"- /€niS PawAn7L 0 ZoningDrstrict <br /> OWNER ADDRESS (Number,Street,City,Stat ,Zip) <br /> -7o C-r) ,e,/<c ,2 l, r 9,4 1 i l/£f 0w G,)Z, 3 S-6 2-5- 0 .Permitted e? <br /> Us <br /> PHONE E-MAILADDRESS <br /> 66 f- $ 3/ 0 3 7 0`.ZoningStatus,; UP; <br /> AGENT INFORMATION CONTRACTOR INFORMATION ''Deed Restriction;.CSM <br /> AGENT NAME CONTRACTOR NAME Variance(# <br /> /j/ wSE•v gvj 7e/co s T hie , fii.AisY Ai /3c,,/dt'c 7wc' <br /> AGENT ADDRESS CONTRACTOR ADDRESS <br /> ❑":Site Plan tlrawitto scale <br /> //6 ign ki S TK S(,°( / 0 i/u £'k f h sf. S v�re 64 Nand includes d nierisions _ <br /> (City,State,Zip) (City,State,Zip) <br /> /A%v.va it--e _ GJ7. s----35-- - 7 C/ti vii,A ,F f. b,-'Z. 5 IS S 7 Li Site Planrncludrng iocation <br /> PHONE PHONE Of well/Septic <br /> 66F- rYi- Y736 lvGk - $ VS - y>3G <br /> E-MAIL ADDRESS E-MAILADDRESS ❑ Setbaoks <br /> /✓s(A✓ 6vi/i£!os & 7/,S . '-- hitA/re-' igv,/isss 76 ./vZ-f <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑-Site Plan approval from:. <br /> PARENT PARCEL NUMBER: ZONING: ACREAGE: appr icable tgwrlShlp <br /> PARCEL og-o-,2 q2/O- O lC K-/ -2` yL i <br /> NUMBER �2' <br /> TOWNSHIP: SECTION: Li RuraAddreS <br /> S <br /> Sp 2,,,q �%L/ .2 O 1/4: s w 1/41/4: it/&,/ , <br /> I clew/existing <br /> ADDRESS: ` + <br /> /1 / el <br /> C S A //3'ti/ . �s ® door plans to��scale <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> //3 y / 2- U--E1evatioriof prgperty <br /> PROPOSED PROJECT INFORMATION frontagedrawn^to.scale <br /> PROJECT DESCRIPTION: <br /> 5 , ,. /t csa fi , /y /Z£s//14,e 0 Driveway perrnr)s <br /> . ®This project is a new building or structure. (state,county,town) <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> 0E Sanitaryperrnits <br /> SANITARY SERVICE: PERMIT NUMBER: (�ubiic pnvate) <br /> 0 SEWER 0 SEPTIC 5-/f02- <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) ❑,Wetland/Rood Ialn/ <br /> p <br /> 02 S- / Shoreland (attadttrnent) <br /> AREA TO NEAREST SQUARE FOOT <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) <br /> © EraslonControl.4ermit <br /> BASEMENT 1ST FLOOR: (5 I0 <br /> es dtstUrba7tce, <br /> „2 r-k6 ti4/6 Z ,, TOTAL SQUARE FOOTAGE: j , <br /> filling/access) ` k <br /> 2ND FLOOR: 3RD FLOOR: <br /> 7 °576r © Review Location$urve, <br /> Y <br /> ESTIMATED CONSTRUCTION COST: arttl available o bons <br /> (Please round to nearest dollar) --► -+ --► $ vas; Qe, <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes 0 No ❑Don't know <br /> 2. There is a wetland or floodplain on or near the property? ❑Yes 0 No ❑Don't know <br /> 3. Have you talked with the township about your project? 0 Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ®No <br /> 5. This project is associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? 0 Yes 0 No :.Don't know <br /> 7. Is this correcting a violation? ❑Yes 0 No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -i <br /> 545-112(1/08) <br />