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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App r <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Reena Vyas/Scott Gilbertson Zoning Status; CUP; <br /> OWNER ADDRESS (Number;Street.City,State,Zip) Deed Restriction; CSM <br /> 1035 Purple Iris Trail#306,Verona,WI 53593 Variance(# l O' ZO ) <br /> HOME PHONE 1 CELL PHONE E-MAIL ADDRESS t t 0'Sal Rg• 6 e <br /> (608)225-5294 (608)215-3553 reena @rzco.com;srgone @yahoo.com Site Plan drawn to scale p"R' <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Justin Temple Temple Builders LLC 0 Site Plan including location <br /> AGENT ADDRESS S�/ CONTRACTOR ADDRESS of well/septic <br /> 2501 W Beltline Hwy,Suite 113 %� 2501 W Beltline Hwy,Suite 113 <br /> (City,State Zip) , c.--) (City.State,Zip) Setbacks <br /> Madison,WI 53713 `.. Madison,WI 53713 <br /> PHONE PHONE ISA.Site Plan approval from <br /> (608) 729-3990 (608) 729-3990 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jtemple @templebuilds.com jtemple @templebuilds.com Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://occossdano.co.dono.wLus/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING ACREAGE <br /> ❑NUMBER 062/0608-052-2501-0 �� 99,322.00 frontage drawn to scale. <br /> TOWNSHIP SECTION <br /> Verona 5 I/: 6N %IA: 08 E/W iveway permits <br /> ADDRESS (state,county own) <br /> Unit 1, Watch Hill Circle <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary permits <br /> 1 Woods at Watch Hill (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION 4.4 Blib(yOOW� _S" I .. <br /> 13°► 1-f WA-I-CH H 18-+- c--. © Zoning District R. LI <br /> . 0 This project is a new building or structure. Q Permitted Use? <br /> JThis project is an addition/alteration to an existing building or structure. �( <br /> SANITARY SERVICE PERMIT NUMBER CJ Rural Address <br /> PEWER PEPTIC 13,201,700,031 existing) <br /> HEIGHT IN FEET NUMBER OF STORIES (Not including basement) <br /> 32.0 2.0 4 Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR A,ErosionCOntrol permit <br /> 1,853.0 2,999.0 + TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR 3RD FLOOR: filling/access) <br /> 1,750.0 0.0 6,602.0 <br /> ZReview Location Survey <br /> ESTIMATED CONSTRUCTION COST: -+ -+ -+ '- -+ -. $ 575,000.00 and available options. <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? LJYes NI No Don't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes ONo Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? JYes INo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Efres JNo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) I-- e blank if none) <br /> 6. Is a location survey required? (see reverse) '(..4Z '/4L ...„,$ !C44. IN • No Don't know <br /> 7. Is this to correct a violation? Mi es 1g No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► <br /> 545-112(4/08) <br />