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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Phil Krejci oning Status; CUP; <br /> V OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 8924 Colby Rd Mt.Horeb WI 53572 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)832-6397 <br /> Ig Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and.ncludes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dennis Dignan Badger Home Improvement Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 144 Glen View Rd 144 Glen View Rd <br /> (Ci ,State,Zip) (City,State,Zip) Igi Setbacks <br /> t.Horeb WI 53572 Mt.Horeb WI 53572 <br /> PHONE PHONE El-gileTplan approval from <br /> (608) 437-5698 (608) 437-5698 applicable township. s <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dennis @badgerhomeimprovement.com dennis @badgerhomeimprovement.com 0 Floor plans to scale _ <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) e <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevation of property <br /> ❑PARCEL 060733390004 Al 20.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Springdale 33 1/4. SW 1/4% SW ❑ Dra VTi mits <br /> ADDRESS: (St CO ty,town) <br /> z 8924 Colby Rd <br /> ❑Sanita ermits <br /> CSM: LOT L SUBDIVISION BLOCK/LOT <br /> (pub. , ivate) <br /> PROPOSED PROJECT INFORMATION 'TAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Detached Garage 3 6 " yVI Woning District <br /> IN This project is a new building or structure. 41.1 <br /> e fitted Use? <br /> UThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: Cll RuralAddr <br /> EWER T EPTIC (new/e " <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) / <br /> )), S 15.0 1.0 Wetla 41:v."plain/ <br /> S orela • (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: <br /> Ero '•n • trol permit <br /> T: <br /> 864.0 j, TOTAL SQUARE FOOTAGE: ,, (SI•• - disturbance, <br /> filli,• -.•;SS) <br /> 2ND FLOOR: 3RD FLOOR: <br /> / 864.0 ❑ Review n Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ and ava. le o ions. <br /> (Please round to nearest dollar) $ 45,000.00 <br /> Q <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? OYes riNo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes No Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Yes JNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes EINo <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) Eyes JNo ❑Don't know <br /> 7. Is this to correct a violation? QYes ✓Zlo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ -► -+ <br /> 545-112(4/08) <br />