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elr6,t [ V <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO P OVIDE <br /> OWNER NAME <br /> Aaron & Melissa Becker ❑Zoning st--z r ( ,c- <br /> OWNER ADDRESS (Number,Street,City,State,zip) Deed Restriction;CSM <br /> 6661 University Ave.#106 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)210-2500 BALLC<aaron @beckeragencyllc.com> ❑Site Plan?veto scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> JM Frederick Custom Homes&Properties,LLC ❑Site Plan• cl Ing location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/se <br /> 1283 County Road D <br /> (City,State,Zip) (City,State,Zip) ❑Setbcs <br /> Oregon,WI 53575 <br /> PHONE PHONE ❑Site Pl. ,ap, „ . ■ <br /> (608) 843-2789 applic-6 : o 7 s ip. <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> freddy.jmfcustomhomes @gmail.com ❑Floor pl S Scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevati o roperty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 004/0807-182-9501-0 37.00 frontag rawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> TOWN OF BERRY 18 IA: SW 1/41/4: NE ❑Driv a ” <br /> ADDRESS: (state, ) <br /> �' . 'co!, ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public,private) reI✓\ <br /> PROPOSED PROJECT INFORMATION ..i# t , ,14' <br /> PROJECT DESCRIPTION: °" <br /> New Home - <br /> . IN This project is a new building or structure. I i i+ <br /> ❑This project is an addition/alteration to an existing building or structure. r� w , ,. <br /> SANITARY SERVICE: PERMIT NUMBER: AA:-:,[;',;.i..,;. a e 4 i. <br /> ..EWER !, pg.EPTIC 13,201,600,250 <br /> HEIGHT EET: V NUMBER OF STORIES: (Not including basement) '', <br /> 35.0 1.o _� 4; ; 'i <br /> ,- pia e ir a'a� :. <br /> AREA TO NEAREST SQUARE FOOT - ; <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) „ L L <br /> BASEMENT 1ST FLOOR: `� }+ +a� ' � <br /> 1,884.0 2,450.0 "`�� ;- <br /> ik �J� TOTAL SQUARE FOOTAGE '�!�{ �)-0' [� � � # ,E^�'� <br /> il"CJ ;)ils rr t <br /> 2ND FLOOR: 3RD FLOOR: , :t e i <br /> t r;� �f.- t„,n$urvey <br /> ESTIMATED CONSTRUCTION COST: ;` , ' },*, ,, <br /> ( ) ♦ -- -� ♦ - ♦ $ 580,000.00 4 t,° <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? .❑Yes ✓❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes JNo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ✓❑Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓❑No <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) Ekes IgNo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ❑✓No <br /> e/l/ f \ APPLICATION MUST BE SIGNED <br /> 545-112(4/08) j(` ( ,!Q 2U (Continue on Back) <br />