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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> , <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Design Homes Inc ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,Crty,Stale,Zip) Deed Restriction;CSM <br /> 600 N Marquette Rd Prairie Du Chien WI 53821 Variance(# ) <br /> HOME PHONE CELL PHONE IE-MAIL ADDRESS <br /> (608)326-6041 dhsales @designhomes.com n Site Plan d awn Cale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and include Imensions <br /> AGENT NAME CONTRACTOR NAME <br /> Lynelle Heinzeroth JNB Signs Chris Cronin El Site PIA I fi I location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of wel Sp c <br /> 410 Pierce Rd 1221 Venture Dr Suite 1 <br /> (City,State,Zip) (City.State,Zip) ❑Setki <br /> Edgerton WI 53534 Janesville WI 53545 <br /> PHONE PHONE <br /> ❑Site PI.Et :� al from <br /> (608) 884-6263 (608) 754-6338 appiic.•I. h hip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dhedgerton @designhomes.com ccronin @jnbsigns.com n Floor pla S t Cale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usq n Elevation pro <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> n PARCEL 01.0512262 4e S ' C-2 2.75 frontage d w o scale. <br /> NUMBER 9 TOWNSHIP: v' t eb ECTION: <br /> Albion F 26 �/4: SW %1/4. NW ❑Drive y colts <br /> (stat �wn) <br /> ADDRESS: <br /> 410 Pierce Rd Edgerton WI 53534 <br /> CSM. 7,703 LOT 1 SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public, : I a - <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: 9' <br /> Out Door Sign � I \Not ,✓ `6- Y,U-i'I l C. ❑ Zoninap sn�c <br /> t <br /> - nThis project is a new building or structure. LI Permittede? <br /> QThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER rEPTIC (new/4E ) <br /> ESE g <br /> HEIGHT IN FEET: _ / NUMBER OF STORIES: (Not including basement) <br /> C�-0 ❑ Wetl:. • plain/ <br /> AREA TO NEAREST SQUARE FOOT: Sho��: d ( chment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) 1---1 Erosi. C./jol permit <br /> BASEMENT: 1ST FLOOR: !r ... ..72....... <br /> ttfl <br /> 1, j TOTAL SQUARE FOOTAGE: + (Slop,:S, •I f :.nce, <br /> 2ND FLOOR: 3RD FLOOR f fillin•/acce+S) <br /> 152.0 ❑ Revie <br /> ESTIMATED CONSTRUCTION COST: and av a tjr.ctilEvey <br /> s. <br /> (Please round to nearest dollar) ♦ -+ ♦ ♦ — $ 13,095.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ✓Nlo QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? nYes FNo QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? QYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? 0Yes nNo <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) ,rIt es pio ['Don't know <br /> 7. Is this to correct a violation? Elves Dslo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -4. -+ —► <br /> 54511202M <br />