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; . ,,,,,,, DANE C`'u Zoning Division <br /> ��,: <br /> :t E V r ENT Room 116,City-County Building <br /> k 210 Martin Luther King Jr. Blvd. <br /> Madison,Wisconsin 53703-3342 <br /> Floodplain Development Application Fa Phone:6 8)267-154i) <br /> Items required to be submitted with application: <br /> o Site Development Plans <br /> Plans shall include scaled drawings of existing topography of the area and proposed final grades of <br /> development. All topographical information shall be in NAVD 1988 and be referenced to a known <br /> benchmark. The plan shall show all existing and proposed building footprints and elevations of lowest <br /> floor elevations. The plans shall include dimensions of ditches,culverts,or other structures existing or <br /> proposed. All plans shall be stamped and signed by a professional engineer or architect <br /> o Engineering Analysis <br /> The analysis shall include calculations or modeling that shows that the development will not obstruct <br /> flow or will not increase the floodwater elevation 0.01 of a foot or more All calculations shall be <br /> stamped and signed by a professional engineer or architect <br /> Owners Name NA( .1 Contractor's Name <br /> r � C \ ddAddress ki ( � ?1C� iC� 6C CY, ress \ - fAe I <br /> 5�t—t--7 212 <br /> Phone r , Phone <br /> ty1 1)i('e?-'TCi_ri1,1 G � c,t \ c 01, <br /> Email Email <br /> Parcel numbers affected: ( l .1(s\ht* "116-5;D Town: } 1(‘a O{h Section: P <br /> {` J i o f c i M i ja',OW-1\C co0 i/ 11°Z 5C;61 J Property Address: Ube - Th .. <br /> Cfc;M ,),S 1 e) cscii-4, wl 5356' i <br /> FEMA Panel Map: Floodplain District: Flood Elevation: <br /> 1 <br /> I <br /> i <br /> Scope of work:(Describe development in detain "?'self s irne Yt>r- 1' cr) T _ <br /> A‘\-6/2,s.1 Y'_ SjC\C.S P'\\ 1'.'? te, a\tk9i6. fl'11 -\'mo`i4i y1,11,10011 Lt.,'I b'_ pirk cod i/7 <br /> e1ds (1A no niD(c4ittri 910t Iii cJepHr. We co,ly also ,ptaez.. 0. id-t. d x n 25'L. uh .r¢ <br /> 1 <br /> I authorize that i am the owner or have ion act on behalf of the owner of the property <br /> Submitted By: yi a„, / _ __ Date: ---/s'_"%.. <br /> I <br /> i <br /> s <br /> 1 <br /> [ - -- *-..--- <br />