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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Michael Shanley ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 437 N McClurg Court Chicago, IL 60611 Variance(# ) <br /> HOME PHONE 1 CELL PHONE E-MAIL ADDRESS <br /> (309)258-7590 mshanley57 @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Udvari-Solner Design ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2631 University Ave., Suite 104 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Madison, WI 53705 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 233-1480 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> design @ udvari-solner.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑NUMBER 046/0611-191-6112-8 R-3 • / frontage drawn to scale. <br /> TOWNSHIP: SECTION i <br /> Town of Pleasant Springs / 1/,: 1/1/. ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2365 Williams Point Drive, Stoughton, WI 53589 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: >> <br /> New boat house construction 0 Zoning District <br /> . 0 This project is a new building or structure. <br /> Perrrttl;Esd llsa? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARYSERV E: PERMIT NUMBER: IJ RZulalAddress <br /> EWER [DEPTIC {Clew//®Xisttttg} <br /> HEIGHT IN FEET: I NUMBER OF STORIES: lot including basement) <br /> ndf loodplainr <br /> Shoraiand'(attat5O1'rlan <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) g° <br /> BASEMENT: 1ST FLOOR: <br /> 448.0 <br /> 448.0 4, (a��,dt t rbance, <br /> TOTAL SQUARE FOOTAGE � lititiigleitttileS) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 448.0 <br /> ♦ ♦ <br /> 0 Reew Loa t ioS rt � <br /> ESTIMATED CONSTRUCTION COST: $ _ / 000 OO SB B D g <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? ❑✓Y s ❑No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? s ❑No ['Don'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? [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 ❑No ['Don't know <br /> 7. Is this to correct a violation? ['Yes Eg No <br /> �Zfl , ' <br /> 0313 O�PLICATION MUST BE SIGNED <br /> 545-112(4/08) II/i ov (Continue on Back) —► <br /> Q 141 <br />