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1 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Leroy Wipperfurth ing Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) eed Restriction; CSM <br /> 7364 County Rd.V Lodi,WI 53555 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)577-9900 (608)577-7924 wippfarm @gmail.com 15I Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Q Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) NI Setbacks <br /> PHONE PHONE ❑Site Plan proval from <br /> applic a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> p Floor plan to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> pg PARCEL 022/908-212-9160-9 A-1 (EX) 30.10 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Dane 21 1/4: NW 1414: SW Drive - •ermltS <br /> ADDRESS: (sta -, ••unty,town) <br /> 7364 County Rd. V Lodi, WI 53555 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanita • its <br /> n/a n/a (pu• . , •ivate) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Construction of 56'x148'Heifer Barn onin g District <br /> 0 This project is a new building or structure. Pe fitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SERVICE: PERMIT NUMBER: -- r�u- Address <br /> EWER rEPTIC (new/ sTirrg 1 <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not induding basement) <br /> 26.0 1.0 cri Wetlas• oodplain/ C4.4.43 <br /> AREA TO NEAREST SQUARE FOOT: or ••� n <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ` <br /> ErosionCo • •ermit <br /> BASEMENT: 0.0 1ST FLOOR: <br /> 8,288.0 8, <br /> U U(J TOTAL SQUARE FOOTAGE: 4, (slopes, 4 isturbanc , <br /> 2ND FLOOR: 3RD FLOOR: filling/acces <br /> --�,^o A <br /> 0.0 0.0 8,288.0 �� , <br /> eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ $ and available options.. <br /> (Please round to nearest dollar) <br /> fvQ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes riNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes allo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ONo <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 is ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes al <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545-112(4/08) <br />