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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 /> Timothy & Jennifer Hoege <br /> n Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City.State,Zip) Deed Restriction; CSM <br /> 5009 Meadow Side Lane Waunakee,Wl Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)206-3026 (608) 206-6208 himtoege @gmail.com ite Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Owner WrSite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City.State.Zip) (City.State.Zip) Vetbacks <br /> PHONE PHONE n Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE I@vatlon of property <br /> El NUMBER Oil oal -31.3— 4 3 7y,a <br /> R-1 0.59 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Vienna IA: 1/41/4: n Driveway permits <br /> (state, county,town) <br /> ADDRESS: <br /> 5009 Meadow Side Ln <br /> n Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 66 (public, private) <br /> Nature Valley Conservation <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Deck ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> IS This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> r EWER F3EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 13.0 1.0 ❑ 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) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: <br /> j TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR 3RD FLOOR: 400.0 BO oa <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ —• -+ -� g 060.00 and available options. <br /> (Please round to nearest dollar) 9,060.00 <br /> The property is within 300 feet of a stream or 1000 feet from a pond or lake? nYes is No Don't know <br /> 2. Is there a wetland or floodplain on or near the property? nYes FNo Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? r✓Yes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? EYes is <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) I-- - blank if none) <br /> 6. Is a location survey required? (see reverse) C P. is No nDon't know <br /> 7. Is this to correct a violation? II es 12 No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —+ -0 -i <br /> 545-112(4/08) <br />