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-1 . <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Ryan Kipp <br /> ❑Zoning S us; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Dee R striction; CSM <br /> 312 Amanda Way, Verona WI 53593 <br /> Varia e(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)217-4801 jfranzen @denoblebuilders.com ❑ Site Plan d to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and include dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Hart DeNoble Builders Hart DeNoble Builders ❑Site Pla In ding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/se is <br /> 7923 Airport Rd 7923 Airport Rd <br /> (City,State,Zip) (City,State,Zip) ❑Set cks <br /> Middleton, WI 53562 Middleton, WI 53562 <br /> PHONE PHONE ❑Site PI a p om <br /> (608) 831-4122 (608) 831-4422 appli b o ns ip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jfranzen @denoblebuilders.com El Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCE NUM R: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL �j ] eR ll frontage drawn to scal <br /> NUMBER © �/✓f7' Q��3� V''eS ( <br /> TOWNSHIP: SECT ON: <br /> Verona '/4: 1A1A: Driveway permits O <br /> ADDRESS: , (state, county,town) .� <br /> 7 & 0 ❑Sanl ry ermlts <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 13 The Woods (publl rivate) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Single Family Res ❑ Zoninc7DDrict <br /> . ISI This project is a new building or structure. ❑ Permit'keiUse? <br /> ❑This project is an addition/alteration to an existing building or structure. VV <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> PIEWER rEPTIC /existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 33.5 2.0 ❑ Wetlan•i o,4-' / <br /> AREA TO NEAREST SQUARE FOOT: Shorela a -c ment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT 1 ST FLOOR: ❑ Erosio •' rol permit <br /> 1 ,427.0 2,985.0 4, TOTAL SQUARE FOOTAGE: 4, (slop , nl, %-rice, <br /> 2ND FLOOR: 3RD FLOOR: filling • •- -s) <br /> 1 ,382.0 5,794.0 ❑ Review urvey y <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ -► and avaj M'?;•.ions. <br /> (Please round to nearest dollar) $ 550,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes CNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes 1ENo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Wes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes Ro <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 al o ❑Don't know <br /> 7. Is this to correct a violation? Dies 151 o <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -♦ ■ -+ <br /> 545-112■4/08) <br />