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ZONING OFFICE USE ONLY ZONING OFFICE USE ONLY <br /> Project includes development within: (check all that apply) <br /> ,_.J1000' of a lake or pond 300' of lake,pond,river or stream A300' of a floodplain <br /> ❑ A floodplain ❑ 75' of a wetland ❑ A wetland ❑ The vegetative buffer zone <br /> Shoreland Water body: 1,-," Identification:)i-Pl40%'/ - DNR designated? Yes ❑No <br /> ❑ Wetland ❑ Shoreland wetland ❑Inland wetland ❑Wetland<2 acres <br /> LFloodplain FEMA map panel: 55025C Q 63/1, 12-/ Flood zone: 6) -E <br /> ❑Floodway Flood fringe ❑General floodplain ❑Flood storage <br /> Lot <br /> xisting ❑ Existing non-conforming ❑New <br /> Impervious Surface Calculations <br /> Area(square feet): <br /> Total Lot: 3-7 6 Sq Ft <br /> 7 p <br /> Within znm of <br /> Dane County Shoreland Zoning Zoning office use only <br /> Permit Application Shoreland Permit#:DCPSFIl_17 - / <br /> Application must be made in person Zoning Permit#$E'PEP- <br /> Shoreland Zoning Permit fee is$150 <br /> A shoreland zoning Permit will be required prior to a general zoning permit being issued by the Dane County <br /> Zoning Division for any development within the shoreland district. <br /> Property Owner Information Agent Information <br /> Name Agent& Kelly Baumbach Agent Name Acker Builders (Jenny Acker) <br /> Address Agent Address <br /> 609 Worthington Drive 331 E. Main Street <br /> City,State,Zip Waunakee, WI 53597 City,State,Zip Waunakee, WI 53597 <br /> Phone Agent Phone <br /> (608) 850-6650 <br /> E-Mail Agent E-mail <br /> Jenny.Acker @AckerBuilders.com <br /> Property/Location Information (http://accessdane.co.dane.wi.us) <br /> Property Address Town/Section NE + + SE Acreage <br /> + % <br /> Kupfer Road Tn Westport,Section 28 �` ` 0.806 <br /> Parcel Number(s) Zoning District <br /> 0809-281-9810-9 Waunakee ETZ <br /> CSM ^ Lot N/A I,^ Subdivision Lands Block/Lot <br /> Project Description <br /> New Home Construction <br />