Laserfiche WebLink
• - <br /> Dane County Shoreland Zoning Zoning dr40v1 <br /> Permit Application <br /> Application must be made in person <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 Name <br /> Johnson Revocable Living Trust Troy Newell <br /> Address Agent Address <br /> 4525 Fox Bluff Lane 12210 Nebraska Ave <br /> City,State,zip Middleton, WI 53562 city,State,zip Los Angeles, CA 90025 <br /> Phone 608 577 6940 Agent Phone 3108266222 <br /> E-Mail Agent E-mail <br /> tkjindra @aol.com newellt @marmot-radziner.com <br /> Property/Location Information (http://accessdane.co.dane.wi.us) <br /> Property Address Town/Section Acreage <br /> 4525 Fox Bluff Ln Town of Westport '% NW 'A'A Sw 3.627 <br /> Parcel Number(s) Zoning District <br /> 066/0709-053-2100-0 ETZ <br /> CSM 6937 Lot 3 Subdivision Block/Lot <br /> Project Description <br /> DEMOLITION OF AN EXISTING RESIDENCE AND DETACHED GARAGE AND CONSTRUCTION OF A NEW RESIDENCE,DETACHED GARAGE.IN-GROUND POOL AND SPA,DRIVEWAY,FLATWORK,LANDSCAPING AND GRADING. <br /> Please answer the following questions to the best of your ability: <br /> Is the property within 300 feet of a stream or 1000 feet from a pond or lake? 8 Yes ❑No El Don't Know <br /> Is there a wetland or floodplain on or near the property? ❑ Yes ❑No 8 Don't Know <br /> Is this project associated with a recent rezone/CUP/variance? BNo If yes, petition/appeal# <br /> Is this permit to correct a violation? El Yes BNo <br /> Have you contacted the Dane County Land and Water Resources Department about this project? ❑Wes ❑No <br /> Most applications must be accompanied by a survey showing the following: <br /> ❑ Property lines with dimensions <br /> ❑ All existing structures Permit Fee due at time of application <br /> ❑ Any proposed structures Please have cash or check payment available <br /> ❑ All impervious surfaces at time of application submittal. Checks are <br /> ❑ All vegetative areas payable to Dane County Zoning. The fee for <br /> ❑ Ordinary High Water Mark a shoreland zoning permit is $150.00 and is <br /> ❑ Topographic data(2-foot contours) non-refundable. <br /> I,the undersigned,hereby make application for a shoreland zoning permit and certify to the accuracy of the information. I <br /> further certify I am the property owner,or a duly authorized representative,and may sign this permit application on the <br /> behalf of the owner(s)of said property. <br /> Applicant signature: 'rtt.oy W4a'Et.t Date: fiect /LJ f:� 2-11i <br /> H:\Zonine\Shoreland-Wetland Zonine\Chapter 11 Forms\DCPSHL Anolication.docx Version 1.1 Created 12272013 <br />