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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUST TO PROVIDE <br /> OWNER NAME <br /> _______Matthew & Jackie Oliver oning Status;CUP; <br /> OWNER ADDRESS (Number, et,City,State,Zip) Deed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL <br /> SI Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Thomas W.Matson Matson Custom Homes, Inc. <br /> Q Site Plan including location <br /> /NT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> .Box 333 1601 E.Main St., P.O. Box 333 <br /> ,State,Zip) (City,State,Zip) Setbacks <br /> Stoughton,WI 53589 Stoughton,WI 53589 <br /> PHONE PHONE 'P ap val from <br /> (608) 873-0500 (608) 873-0500 appl'c ownship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tmatson @matsonhomes.com tmatson @matsonhomes.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER:.360 _n CURRENT ZONING:#0 s ACREAGE: INI Elevation of property <br /> Wi PARCEL 0510-1346258-4— A-2(1) 7 1.25 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Rutland 13 <br /> 1/4: +/4+/4: eway permits �0 <br /> ADDRESS: i ' /// <br /> (state,county,town) <br /> Hwy A \ �/IJ H Sanitary permits `>• ' <br /> CSM: LOT SUB !VISION BLOCK/LOT <br /> 14,503 2 (p ubl. , • •- - <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: <br /> to <br /> New Home Construction ',4''1", - <br /> NI This project is a new building or structure. , ,° <br /> P 1 9 t �;� , ry,. <br /> ❑This project is an addition/alteration to an existing building or structure. , ,:Y r <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> W qY' <br /> M <br /> EWER EPTIC M1- aD1-1` p163 t ,t , <br /> HEIGHT IN FEET:-� NU ER OF STORIES: (Not including basement) , . " * ' <br /> " ax . a I 1. <br /> AREA TO NEAREST SQUARE FOOT: ` � ' j <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) "' <br /> BASEME 1SVLOOR: 04 „).P" <br /> J <br /> ' G. 3�G + TOTAL SQUARE FOOTAGE: 1 *■. ° , ' <br /> 2ND R: 3RD FLOOR: 1133 \ <br /> ESTIMATED CONSTRUCTION COST: , <br /> (Please round to nearest dollar) ♦ ♦ -+ -+ -♦ -* $ 290,000.00 <br /> , <br /> I v 7 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Dies ONo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes NI No <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 ENO ❑Don't know <br /> 7. Is this to correct a violation? ['Yes rNo <br /> /? V APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545-112(4/08) <br />