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<br /> 4;4� DANE C O U gT Zoning Division
<br /> �b
<br /> :r 1,, PLANNING
<br /> �, Room 116,City-County Building
<br /> 210 Martin Luther King Jr. Blvd.
<br /> ' Madison,Wisconsin 53703-3342
<br /> 08086 4266
<br /> Floodplain Development A pp lication Fax: (6 o8)287-1540
<br /> Items required to be submitted with application:
<br /> o Site Development Plans
<br /> Plans shall include scaled drawings of existing topography of the area and proposed final grades of
<br /> development. All topographical information shall be in NAVD 1988 and be referenced to a known
<br /> benchmark. The plan shall show all existing and proposed building footprints and elevations of lowest
<br /> floor elevations. The plans shall include dimensions of ditches,culverts,or other structures existing or
<br /> proposed. All plans shall be stamped and signed by a professional engineer or architect.
<br /> o Engineering Analysis
<br /> The analysis shall include calculations or modeling that shows that the development will not obstruct
<br /> flow or will not increase the floodwater elevation 0.01 of a foot or more.All calculations shall be
<br /> stamped and signed by a professional engineer or architect.
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<br /> Owners Name S s P y, ,-,rs ( ,,,,,..pc,, ' ,,...„,1 Contractor's Name iYr'_'C F.;xc t� .ar ca
<br /> Address � s0 :.: }t , �'r '; �°;';' LA.'S.. Address ` e5=-:'•,E,- ` .'C'.a
<br /> Phone
<br /> Email Email
<br /> Parcel numbers affected: c)SO% 15 3 s s e1 1 Town: rr, r_-> is`'.•-N Section: \,'S
<br /> sr� /c,SSe etc, C Q�8 15�, 9Sa! Property Address. ° "/q '` 4 h
<br /> FEMA Panel Map: Floodplain District: Flood Elevation:
<br /> Scope of work:(Describe development in detail) -
<br /> C3,-€-c-'fit:.
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<br /> '�' 1"'t{':td�:,3� �.�+F'�.� '��.7\:0",-..C'- ‘:, Cr...�grod'7°e.C) .+a r.,. ,�, .,•_1".�, Via, ..t�a-52...a ;t.. �:>d.0.,S"°, '�°-�,';�
<br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property.
<br /> Submitted By: Date: ' -' : -n
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