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• <br /> ZONING PERMT APPUVAT1VN minrecoultyofdar»oom SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME Angela Kirsch <br /> ❑Zoning Status;CUP; <br /> o VgD cei c N Ib d ge mI t r aItd de ton, WI 53562 Deed Restriction;CSM <br /> Variance(# ) <br /> H°615 Hg E8-2435 CELL PHONE E-MAIL ADDRESS <br /> ((jj �(jjL ❑Site Plan drawn to scale <br /> AGENT INFORMATION IC�ONTRACTTOR INFORMATION and includes dimensions <br /> G <br /> AGENT NAME lia son° exteriors <br /> ❑Site Plan including location <br /> AGENT ADDRESS Cyo12AC0aywoECI Ave of well/septic <br /> (City,State,Zip) (Vic cifeton, WI 53562 <br /> 1=I Setbacks <br /> PHONE PHONE 1=I Site Plan approval from <br /> 608-217-3373 applicable township. <br /> E-MAIL ADDRESS E-MAI L ADDRE <br /> ryangralstonexteriors.com ['Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑NUMBER (3. 0%- 1-6'a6y —3 K^ I 6, Co frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Springfield e?, 9 y... AI f 1/4'/4: /Q F ['Driveway permits <br /> ADDRESS: (state,county,town) <br /> 5276 Scenic Ridge Trail, Middleton, WI 53562 <br /> CSM: LOT SUBDIVISION BLOCK/LOT CI$anitary permits <br /> a Prrs+,. - 1-1%‘\s (public,private) <br /> PROPOSED PROJECT INFORMATION ft <br /> P OJECl D SCRIpTION: <br /> Repair�ack porch area, convert from enclosed porch to exposed deck - -k , ; y. <br /> . ❑This project is a new building or structure. �. � <br /> MI This project is an addition/alteration to an existing building or structure. �� �' s <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> EWEREPTIC � <br /> HEIGHT IN FEE NUMBER OF STORIES: (Not including basement) ` <br /> 1 n � . ;: <br /> AREA TO NEAREST SQUARE FOOT: - . <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: 'j � i9 {€z i <br /> TOTAL SQUARE FOOTAGE: b <br /> f Yg�, k <br /> 2ND FLOOR. 3RD FLOOR: <br /> 134 ‘F arm ; <br /> ESTIMATED CONSTRUCTION COST: _, _p _p _p 2,500.00 �� <br /> (Please round to nearest dollar) o`. � ��� .. <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Efres Alo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes o ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Yes 'lo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# z ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) /,$71 6 ['Yes "lo DDon't know <br /> 7. Is this to correct a violation? ❑Yes 14,0 <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► ♦ -0 <br /> 545-112(4/08) <br />