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9, ..--/ .--- IL-1;,7 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Kathy Jasper ❑Zoning St tus; C <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Res Icti CSM <br /> 5111 Vienna Dr Waunakee WI 53597 Variance( ) <br /> HOME PHONE 'CELL PHONE E-MAIL ADDRESS <br /> (608)445-8275 (608)445-8275 kathyjasperl @gmail.com ❑Site Plan dra to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes di ensions <br /> AGENT NAME CONTRACTOR NAME r' <br /> AGENT ADDRESS CONTRACTOR ADDRESS ❑Site Pla n I 1 ; 'cation <br /> of well ptibf <br /> I <br /> (City,State,Zip) (City,State,Zip) El Set aC <br /> PHONE PHONE ❑Site Plana rot i <br /> - applicablo n I� <br /> E-MAIL ADDRESS E-MAIL ADDRESS EEC 71q, <br /> donniegriff @gmail.com ❑Floor pla o c <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi-us/) ID Elevatio of• .1 - <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 0909-354-6150-4 R1 0.79 frontag:/: : n it scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: • r <br /> Vienna /4: /4A: <br /> ❑Drivewa�,yR <br /> state,ci3un ' to n <br /> ADDRESS. 5111 Vienna Dr Wauankee WI 53597 /4A: (state, <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑San y p: r <br /> 10 SUBDIVISION c, . e <br /> Hickory Meadows <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Rebuild Deck --� .' if :Al 'ij ( .. '',� ../k i,. , ` ❑ Zoning Ai strict <br /> iC <br /> . Iti I' project is a new building or structure. -•) <br /> ❑ Permitt J 'se? <br /> •This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVI • PERMIT NUMBER: ❑ Rural Address <br /> R PTIC (new/e� <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> ❑ Wetlan•/FI.•t ilk,in/ <br /> AREA TO NEAREST SQUARE FOOT: Shor. : d (- •• ) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ (slopes,disturbance, <br /> permit <br /> 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: �/ <br /> �j El Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ ,—^ and available options. <br /> (Please round to nearest dollar) �1 <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 o ❑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? Elves ✓❑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 ✓lNo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► —► -i <br /> 545-112(4/08) <br />