Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> brad dietz ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 3743 oakwood dr cottage grove wi 53527 Variance(# ) <br /> HOME PHONE i CELL PHONE E-MAIL ADDRESS <br /> (608)235-8029 " (608) 516-7000 badietz @charter.net ['Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> 13Cctit,l Q.l.t - ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS, of well/septic <br /> .3 713 000 ci t <br /> (City,State.Zip) (City,State,gZip) _ ❑ Setbacks <br /> PHONE PHO /VG &/`p�JC �� 535 2, ❑ Site Plan approval from <br /> (ri '2_35...30 2 1 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRSS i <br /> B d,b'e Z. ( t t/./k%� <br /> ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 018/0711-204-5378-2 r-1 0.62 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> cottage grove /4: Y<Y4: n Driveway permits <br /> ADDRESS' (state, county,town) <br /> 3743 oakwood dr ❑Sanitary permits <br /> CSM: LOT 8 SUBDIVISION BLOCK/LOT <br /> bohnsack (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> above ground pool Li Zoning District <br /> . <br /> This project is a new building or structure. Li Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER SEPTIC (new/existing) <br /> HEIGHT IN FEET. NUMBER OF STORIES: (Not including basement) <br /> 4.0 ❑ Wetland/Floodplain/ <br /> Shoreland (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: ,---, ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: + (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR 3RD FLOOR: <br /> 288.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ QQ�� and available options. <br /> (Please round to nearest dollar) $ ,e:45:30 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies QNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? IYes is No ['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? [Yes ❑No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# 34----1-) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Dies ONo ['Don't know <br /> 7. Is this to correct a violation? Dies cm No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) —0. -0. <br />