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ZONING PEFIVIT APPL.ICA11014 wwwcouityofdl com =3=7 <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME //�� <br /> i-te.phen 'D .bra k IT Y 71Zoning Status:CUP; <br /> O ER ADppRESS (Number,Str t,City.State,Zip) Deed Restriction;CSM <br /> o29$S Not-WeC{i rti /ra(1 Tf, reji G(.).L c--..3s--17 d— Variance(# ) <br /> HOME PHONE CEL HONE E-MAIL ADDRESS <br /> 6, - ' - ;3.7 60 g-370--07s✓ •cue- works . ,, ' , Carr la Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMAti ION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> /'�llD/-i'Dn 1�uc.Lc(,ra -s IN <br /> Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> _2.35-s Chris /V4_ A1,tr Rd <br /> (City,State,Zip) (City.State,Zip) NI Setbacks <br /> ,.DodgQ V/Ilc Lc)E s 35 33 <br /> PHONE PHONE ✓ ❑Site Plan approval from �o <br /> 6 o$ - 7*_ 7'6, applicable township. <br /> o.?k �� <br /> �E-MAILADDRESS i8p1/c�fi ‘,\K3*r Avrs JVCf en <br /> ERFloor plans to scale <br /> u • g I . • • 'i ' S _.i <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.danemLus/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: a Elevation of property <br /> ®NUM ER 06010539 36. 2_6 II -I , fit <br /> frontage drawn to scale. <br /> TOWNSHIP. SECTION. '/4/:� Tlr/ Vewa <br /> y permits S ri ✓ U(ot 6. -Sw '/4: .54) , (state,county,town) <br /> _ <br /> ADDRESS <br /> ' R 1 E <br /> , 9 gJ A/ /ZU�e at.ri ,,..122_Zn�� X35 1 - cliiilitani permits 'V _ <br /> CSM £!OT SUBDIVISION --BLOCK/LOT (public,private) f�- <br /> No. D 830$ <br /> PROPOSED PROJECT INFORMATION . .. STAJFF,REVIEW <br /> PROJECT DESCRIPTION. <br /> ,0 / _ oning District <br /> This project is a new building or structure. 445;;-rmitted Uses <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ‘0 <br /> tsttn ). <br /> EWER [WEPT I C g <br /> HEIGHT IN FEET: NUMBER OF STORIES' (Not including basement) / <br /> / ,.r 1 /0. S ,, mem I11/3,( j f`�5111ettand/F000dpiain/ <br /> T — — Shoreland (attachment), <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) rosionControl permit <br /> BASEMENT: 1ST FLOOR: ( j TOTAL SQUARE FOOTAGE: , (slopes,disturbance, r C <br /> ) <br /> 7Q e S F <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR. <br /> ( qt, g SF \ er(ew Location Survey I() <br /> ESTIMATED CONSTRUCTION COST: r — and available options. / VVv <br /> (Please round to nearest dollar) ♦ ♦ ♦ J l9'!�� <br /> i <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? DYes [ Jo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? DYes \Jo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? EYes ao <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes \Jo <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) DYes ®No ❑Don't know . <br /> 7. Is this to correct a violation? DYes 'Jo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -i -+ <br /> 545-112(4/08) <br />