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*IIOoo <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> James Lugge <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 2097 River Estates Lane Stoughton WI 53589 Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (847)561-3113 jlugg13 @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Recreational Concepts, Inc. ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 121 N Main St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Oregon WI 53575 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 835-2780 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> recconinc @ymail.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 /> ❑PARCEL 046/0611-291-8460-2 R-1 2.31 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Pleasant Springs '/a: '/a'/4: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2097 River Estates Lane Stoughton WI ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> in-ground 20'x 40'swimming pool ❑ Zoning District <br /> This project is a new building or structure. <br /> ❑ Permitted Use? <br /> ['This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER E}EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ Erosion Control <br /> BASEMENT: 1ST FLOOR: <br /> 4 permit <br /> TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: 800.0 <br /> C7 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ _ ♦ ♦ ♦ and available options. <br /> (Please round to nearest dollar) $ 5 Ubc C b <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Elves OVo r2Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres ODon'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 ✓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 �Jo 12Don't know <br /> 7. Is this to correct a violation? [Yes EJo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(aioa) (Continue on Back) -► -1 -► <br />