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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> James and Diana Murphy <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 8877 Table Bluff Road, Cross Plains, WI 53528 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)767-3443 (608)695-9372 murphome @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Margaret Radix Heartland Building& Design, LLC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 10559 Sutcliffe Road 10559 Sutcliffe Road <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Black Earth, WI 3515 Black Earth,WI 53515 <br /> PHONE PHONE <br /> ❑Site Plan approval from <br /> (608) 438-6766 (608) 438-6766 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> meg @heartlandbd.com meg @heartlandbd.com Q Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevation of property <br /> ❑PARCEL 0807 282 9532-9 A2 25.47 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Berry ,/4: 114: ❑Driveway permits <br /> (state,county,town) <br /> ADDRESS. 8877 Table Bluff Road, Cross Plains,Wl 53528 <br /> CSM: 8,161 LOT 1 SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Adding a side porch to home, demolishing a sunroom ❑ Zoning District <br /> ID This project is a new building or structure. <br /> ❑ Permitted Use? <br /> 11 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER [EPTIC (new/existing) <br /> HEIGHT IN FEET: . NUMBER OF STORIES: (Not including basement) <br /> Q I 1.5 ❑ Wetland/Floodplain! <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: ❑ ErostonControlpermit <br /> /J (/ j TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 105.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: Q and available o tions. <br /> (Please round to nearest dollar) ♦ -+ ♦ ♦ -' 35,985.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes E❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes EIlo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? :Yes Eigo <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) ❑Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes Elo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► <br /> 545-112(4/08) <br />