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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 /> Robert Troia <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 4448 Celestial Circle '`cis WI 53528 Variance(# ) <br /> HOME PHQ�1�*�"CE L��I( E-MAIL ADDRESS <br /> KG Illrrr (608)516-9005 cynthiatroiabeth @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME JUL 1 0 1 CONTRACTOR NAME <br /> Recreational Concepts Inc ❑Site Plan including location <br /> AGENT ADDRESS ENT CONTRACTOR ADDRESS of well/septic <br /> PLAKNV°" 121 N Main St <br /> (City,SttACO (City,State,Zip) ❑Setbacks <br /> Oregon WI 53575 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 835-2780 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> recconinc @ymail.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMB R: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 020/07102-8801-4 RH3 15.64 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Cross Plains 1A: 1/a'/a: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 4448 Celestial Circle Cross Plains WI <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 9,288 4 ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 18'x 33'above ground,swimming pool with deck around it ❑ Zoning District <br /> . ❑This project is a new building or structure. <br /> ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER PEPTIC \ (new/existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement)900 ❑ <br /> AREA TO NEAREST SQUARE FOOT <br /> Shoretartd i<a�ment) <br /> (Outside dimensions including unfinished area attached garages and above grade dec or porches) <br /> BASEMENT 1ST FLOOR: iwI SK)rl 11 Idl nn <br /> 4 TOTAL SOU E FOOTAGE: ,' (slopes,disturbance, <br /> (644, filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> C- b Ei fievieW L <br /> ESTIMATED CONSTRUCTION COST: !i " antdav,,r:,i -options. <br /> (Please round to nearest dollar) ♦ -♦ ♦ -♦ ♦ -♦ $ cjUo ( / <br /> S.210P <br /> 1. The roe is within 300 feet of a stream or 1000 feet from a and or lake? ' <br /> property rty pond Yes �Vo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes Jo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? EaYes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ['Yes ao <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 Flo ❑Don't know <br /> 7. Is this to correct a violation? Oyes Elo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) - -► <br /> 545-112(4/08) <br />