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SUPPLEMENT to Web-App# <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Gary Beal Z ng Status; CUP; <br /> ER ADDRESS (Number,Street,City,State,Zip) <br /> 4792 Felland Rd Madison Wi eed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)852-3670 beatfarmer1234 @gmail.com a Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and inclu s dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cleary Building Corp S. Plan including locati.n_ <br /> AGENT ADDRESS CONTRACTOR ADDRESS f <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) backs <br /> Verona,WI <br /> .. PHONE -\ PHONE ❑Site Pla oval from <br /> (608) 379-0132 applic e wnship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tleeser @clearybuilding.com FI r pl S to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P y <br /> ❑PARCEL 014/0810-354-9160-5 A-1 1.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Burke 35 IA: SW .1/4%: SE ❑Drivew rmits <br /> �i' ADDRESS: (stat , nty,town) <br /> 4792 Felland Rd Madison, WI <br /> CSM: V ST SUBDIVISION BLOCK/LOT El Sa(pu b ni rmits ai. ate) <br /> PROPOSED PROJECT INFORMATION 9` STAFF REVIEW <br /> PROJECT DESCRIPTION: (� "� ., <br /> 24x32 Storage shed p‹eS ar mg:District ' <br /> Fir f <br /> . rA This project is a new building or structure. Per . _. Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: RUralAdd -ss <br /> EWER [EPTIC ire e,, • <br /> EIGHT IN FEET: NUMBER OF STORIES. (Not including basement) <br /> 14.3 1.0 m , - ...plain/ <br /> AREA TO NEAREST SQUARE FOOT: Sharelan*" -=achment} <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) '''',;+' , <br /> BASEMENT 1ST FL0 ti . permit <br /> 1 TOTAL SQUARE FOOTAGE: 4, (slopes, •,- ',once, <br /> 2ND FLOOR. 3RD FLOOR filling(- Ces5�. <br /> 768.0 <br /> Rev Loca ' Survey <br /> ESTIMATED CONSTRUCTION COST: QQ�� and oval O tions. <br /> (Please round to nearest dollar) - —p -p — $ 20,000.00 p ; <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes pi No ❑Don' <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes FilNo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes 1g No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? nYes igiNo <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) ❑Yes 4No EDon't know <br /> 7. Is this to correct a violation? ❑Yes IgiNo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -+ -+ <br /> 545-112(4108) <br />