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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 /> Frank & Brenda Gobel <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 7324 E Cates Rd Belleville WI 53508 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)636-5130 (608)636-5130 gobsgto@aol.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Recreational Concepts Inc ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 121 N Main St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Oregon WI 53575 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 835-2780 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> recconinc @ymail.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) El Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 040/0508-212-9770-0 G1 2.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Montrose 1/4: %/1/4. ❑Driveway permits <br /> ADDRESS. 7324 E Cates Rd Belleville WI 53508 (state,county,town) <br /> csM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 2,798 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> In ground swimming pool with deck ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> 0 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: CI/RuralAddress <br /> EWER rEPTIC V i <br /> HEIGHT IN FEET NUMBER OF STORIES: including basement) ❑ Wetland/FlOOdplalr>d <br /> � <br /> AREA TO NEAREST SQUARE FOOT Shoreland (attachment), <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> l /r <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: C� <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ (�� and available options. <br /> (Please round to nearest dollar) aLl rn,,, <br /> 1 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes Olo EDon't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes a. Don 't know <br /> 3. Have you talked with the township about your project and are they in agreement? ®Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes to <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 `ire'■ o ['Don't know <br /> 7. Is this to correct a violation? ❑Yes !1, o <br /> �7 0 t is APPLICATION MUST BE SIGNED <br /> 0 f C. (Continue on Back) —► -♦ -i <br /> 545-112(4108) 6-1 4 7Li‘ <br />