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e((' a (,c - 6q7— <br /> • <br /> •I, /i.'j ' <br /> 7771 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Henry Land LLC <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 7794 Patton Rd.,Dane,WI 53529 <br /> HOME PHONE 1 CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (608)846-4112 (608)575-1727 joe @henryfarmslic.com 0 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Bonntrager Const. 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> W2432 Cty E <br /> (City.State,Zip) (City,State,Zip) El Setbacks <br /> Cambria,WI 53923 <br /> PHONE PHONE Site Plan approval from <br /> _ (920) 296-6068 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER' CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> Q PARCEL 0909-033-8500-4 A-1-Ex;A-B 40.00 frontage drawn to scale. <br /> NUMBER _ <br /> TOWNSHIP: SECTION: <br /> Vienna 3 +/4 NW +/,+/4: SW ❑ Driveway permits <br /> ADDRESS: (state, county, town) <br /> ' ' " " ` 0 Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT P <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Agricultural storage shed ❑ Zoning District <br /> ZThis project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER SEPTIC (new/existing) <br /> HEIGHT IN FEET: ` i NUMBER OF STORIES: (Not induding basement) <br /> :\ 1, 22.0 1.0 ❑ Wetland/Floodplain/ <br /> Y Shorela chment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionCOntrol permit <br /> 5,000.0 4, TOTAL SQUARE FOOTAGE: 4, 1 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access <br /> 5,000.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) "'� -+ -°' ♦ .- $ 100 000,00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? fYes 151No QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres EjNo (Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ✓ Yes LNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? n7/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) nYes 4No UDon't know <br /> 7. Is this to correct a violation? nYes nNo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) -11. -► -0 <br />