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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 /> Scott Frank <br /> MI Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1986 Rathert Rd,Cottage Grove,WI 53527 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)663-8600 sfrank©oakparkplace.com <br /> Q Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Tyler Weavers Oak Park Place S. Ian including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/sep <br /> 719 Jupiter Drive 719 Jupiter Drive <br /> (Ci ,State,Zip) (City,State,Zip) Set•- ks <br /> Bison,WI 53718 Madison,WI 53718 <br /> PHONE <br /> ����//// ❑ Site -n - -'royal from <br /> PHONE (608) 729-2992 (608) 729-2992 appli -= - township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> tweavers©oakparkplace.com tweavers @oakparkplace.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING- ACREAGE: ion of property <br /> El NUMBER 018/0711-114-8950-0 A-2(8) 10/k) 11.10 rontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Cottage Grove I4. +/,/4_ ❑Driv rmits <br /> ADDRESS: (Sta , linty,town) <br /> 1986 Rathert Rd, Cottage Grove, WI 53527 <br /> ❑Sani ry permits No Sa <br /> CSM: 12,862 LOT 1 SUBDIVISION BLOCK/LOT (publi vale) /) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: �, � <br /> Addition to existing out building/shed. �,iJ x�� t�Loning District <br /> . <br /> This project is a new building or structure. ermitted Use? <br /> 0 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUM R: ral Ad <br /> EWER _EPTIC IV (new/ <br /> .�HEIGHT IN FEET:_�� NUMBER ST RL: (Not including basement) <br /> /� 1.0 W e =•d/F ••dplain/ <br /> V`�� Shor: = • attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> Ero <br /> BASEMENT: 1ST FLOOR: <br /> '•nCon .I permit <br /> 57 .O + TOTAL SQUARE FOOTAGE: 4, (slope , •' turbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> fillip• -cc- s) <br /> 576.0 Revie , • ation Survey <br /> ESTIMATED CONSTRUCTION COST: and - =1 ab • eons. <br /> (Please round to nearest dollar) —P ♦ --� —. —• ♦ $ 17,000.00 p <br /> `//5 <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 ❑No MI Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Dees ENo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes JNo <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) Dies Dlo ❑Don't know <br /> 7. Is this to correct a violation? :Yes ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ♦ —► <br /> 545-112(4108) <br />