Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION Cu,TOMER TO PROVIDE <br /> OWNER NAME <br /> Paul & Traci Hausz <br /> L Zo ing Status; CUP; <br /> OWNER ADDRESS (Number.Street,City,State.Zip) <br /> ed Restriction; CSM <br /> 69 Hoopen rd <br /> ar' nce(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)206-5623 (608)206-5623 hauszcontractors @gmail.com to Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION nd includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Hausz Contractors INC S'a Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS o well/septic <br /> 69 Hoopen RD <br /> (City.State.Zip) (City,State,Zip) et%asks <br /> Cambridge wi 53523 <br /> PHONE PHONE ❑S' - Plan proval from <br /> (608) 206-5623 - r pli le township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> hauszcontractors @gmail.com V r loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of prope <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE. la <br /> ❑PARCEL 016/0612-361-8080-5 A-2 DCPREZ-0000-03158 9.05 frontage dra o scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> CHRISTIANA 36 1/4: NE 1/41/: N '= ❑ Driv ay permit <br /> ADDRESS: (St te,coun , own) <br /> 69 Hoopen rd Cambridge WI 53523 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sani . permits <br /> 4li ,private) <br /> PROPOSED PROJECT INFORMATION ! AFF REVIEW <br /> PROJECT DESCRIPTION: / <br /> AG Pole Building 7 X LI s filling District <br /> . fil This project is a new building or structure. Li Permitted U e? <br /> This project is an additio alteration to an existing building or struct e. <br /> SANITARY SERVICE: PERMIT NUMBER: C 1 ❑ Rural A ress <br /> EWER EPTIC v (new/exis 1 <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 16.0 1.0 ❑ Wetlan oodplai <br /> Shore nd (a men() <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ Erosion ontrol permit <br /> 4, TOTAL SQUARE FOOTAGE: 4, (slop ,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: fllhn /access) '1 <br /> 3,240.0 <br /> ❑ Re iew Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ .- -+ 38,500.00 and available options. <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies rNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes ONo EDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dies '4No <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) Elves '4No ❑Don't know <br /> 7. Is this to correct a violation? Dies FNo <br /> APPLICATION MUST BE SIGNED <br /> qr'"—"'— (Continue on Back) -+ -+ <br /> 545-112(a/oel <br /> 41 C") f) el .s <br />