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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 /> Mike and Hilary Walters Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 2338 Jeffry Trail madison Wi 53719 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)225-5347 mriwealters @gmail.com [Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jim Coons Coons const of verona IIc [l Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1827 Locust drive same <br /> (City,State,Zip) (City,State,Zip) []Setbacks <br /> vwerona WI 53593 same <br /> PHONE PHONE ®Site Plan approval from <br /> (608) 444-4407 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jncoons @chorus.net same []Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: El <br /> ElPARCEL frontage drawn to scale. <br /> NUMBER b(ODr^OSZ- Z'So't-a - '-t 2.o€ .AG <br /> TOWNSHIP: SECTION: 1DW+-I <br /> verona 5 +/.: +/.+/.: [J Driveway permits <br /> ADDRESS: (state,county,town) <br /> unit 3 old oak pass 3(coy L,,.-rcH4tLL. C-t12.. <br /> Er <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary permits <br /> woods at watch hill (public,private) <br /> PROPOSED PROJECT INFORMATION <br /> REVIEW <br /> PROJECT DESCRIPTION: <br /> new single family home ❑ Zoning District <br /> . This project is a new building or structure. CI Permilted Use? <br /> This project is an addition/alteration to an existing building or structure. .1.1.1 <br /> SANITARY SERVICE: <br /> EWER �/ EPTIC PERMIT NUMBER:1 3,201,700, 1 1 1 0 RuralAddress <br /> HEIGHT IN FEET: 32.0 NUMBER OF STORIES: (Not including basement) <br /> AREA TO NEAREST SQUARE FOOT: Sftorand (attachment) <br /> T <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) �tO. pew <br /> BASEMENT: 1,c86.0 1ST FLOOR: 4 TOTAL SQUARE FOOTAGE: j ( +pes,disturbance, <br /> Jpv� .3�K°I ) <br /> 2ND FLOOR: 1,484.0 3RD FLOOR: 6,319.0 7 <br /> U Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: 8nd avaiiale pptipgtS, <br /> (Please round to nearest dollar) - - ♦ - —' ". $ 481,888.00 <br /> $ S 143 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes [lo t/�on't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes Dtio ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Q✓Yes Dlo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes Ilo <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 JVo ✓Don't know <br /> 7. Is this to correct a violation? [Yes EINo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -► -► <br /> 545-112(4408) <br />