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r <br /> • <br /> • <br /> Dane County —ZPNING PERMIT APPLICATION PERMIT NO. <br /> I / ' 1Q4 /`/E .a i TOWN eslx SECTION Y. <br /> NUMBER ROAD /�/ /'7 '7/ / LB�.��C \/ 3//3 y f Z-77? f( i7 C.U.P.NO. ZON LOT BLOCK SUBDIVISION NAME OR C.S.M.NUMBER <br /> ROAD <br /> PROPOSED USE: <br /> -g 001 ONE FAMILY BUILDING ❑013 SERVICE STATION/GARAGE <br /> CLASS /❑002 TWO FAMILY BUILDING 0 014 HOSPITALS/INSTITUTIONS <br /> WIDTH wV / ❑003 THREE/FOUR FAMILY BUILDING ❑ 015 OFFICE/PROFESSIONAL <br /> • ❑004 FIVE/MORE FAMILY BUILDING ❑ 016 <br /> UBIC WORKS/UTILITY <br /> TYPE OF IMPROVEMENT: ❑006 TRANSIENT HOTEL/MOTEL ❑ 017 SCHOOLS/EDUCATIONAL <br /> [NEW BUILDING ❑008 AMUSEMENT/RECREATIONAL ❑ 018 STORES/MERCANTILE <br /> _ 0 009 CHURCHES/RELIGIOUS ❑ 019 OTHER NON-RESIDENTIAL <br /> ❑ADDITION 020 TANKS/TOWERS <br /> ❑ALTERATION ❑010 INDUSTRIAL BUILDING 0 nay ADDITION/ALTERATION RESIDENTIAL <br /> ❑REPAIR/REPLACEMENT ❑011 PARKING GARAGE <br /> • ❑MOVING/RELOCATION ❑012 RESIDENTIAL GARAGE �@ <br /> •.TFRATION NON-RESIDENTIAL <br /> • TYPE OF FRAME: PROPOSED USE: (If non-residential,c R��r �� �eivrit <br /> yOOD FRAME <br /> ❑MASONRY(WALL BEARING) <br /> ❑STRUCTURAL STEEL <br /> ❑REINFORCED CONCRETE <br /> ❑OTHER OWNER: <br /> SEWAGE DISPOSAL: 7-2-,/ (N), ‘-,./(< 5/7aL" 5 <br /> ❑PRIVATE /-1/7A54,-) 537/ - <br /> PERMIT NO CONTRACTOR: 11 <br /> DIMENSIONS: �)j 3/,�o t/ F .."—,�G , 7—;j //'e <br /> • LONG_ YL/ / WIDE S / /63z- W A-.-.,9/4/ 5T �4. ZO% . <br /> STORIES / FEET —5641 ,./e1/,, <br /> TOTAL FLOOR AREA The u " signed and t ,owner of this building agree to conform to all applicable ordinances of Dane County. <br /> TOTAL LOT AREA `J��c Data <br /> • Sign. ure of owner or his agent <br /> PARKING SPACES: <br /> INSPECTION RECORD: QS /e. Z2G/ e5 5/r;/91,05--s <br /> REQUIRED FRONT YARD I / RIGHT YARD �� LEFTY 'D '.AR YARD ✓ <br /> FURNISHED_. /L_'5 i / B\' .! r *v <br /> SHORELAND/FLOOD PLAIN' <br /> DATE. CERTIFIC Etc^ Fs ! BY <br /> NOTATION: _r� <br /> `PERMIT NO. j�tU.'^ _ c; i//1 _5t--/. ...k`'.5?.s <br /> VARIANCE `J <br /> l..PERMIT NO. <br /> DWELLING UNITS l003{'O41 / <br /> tar sa <br /> 1 BEDROOM. I AREA. <br /> !BASEMENT ` FIRST i/ SECOND TOTAL <br /> 2BEUROOM I / <br /> ,38EOROOAS iC0 S •- o F= 9la <br /> � -4U 'i <br /> DATE <br /> ISSUED Bt <br /> ITDTAL <br />