Laserfiche WebLink
SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Brian Summers <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> 2828 Waubesa Ave.Madison Wi.53711 Deed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)513-3715 bsurnmers90 @hotmail.com Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> _ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,zip) Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> 151 <br /> Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessNING: co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevation of property <br /> PARCEL 0610-082-1633-0 R-3 0.21 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: ❑ DrIV @Way permlt5 <br /> Dunn 8 '/a: NW '/4'/a: SE (state,county,town) <br /> ADDRESS: <br /> 2828 Waubesa Ave. Madison Wi, 53711 <br /> CSM: LOT SUBDIVISION T :BLOCK/LOT ❑Sanitary permits <br /> 13,303 2 Waubesa Beach 2,z (public,private) <br /> PROPOSED PROJECT INFORMATION = , -, <br /> PROJECT DESCRIPTION: t � , <br /> Tear down,re-build �`Qttlt, ' <br /> 0 This project is a new building or structure. <br /> C3 Permitted ,1 ? <br /> This project is an addition/alteration to an existin buildin or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 0 Rural Address <br /> EWER rEPTIC �w/e�n3) <br /> HEIGHT IN FEET: <br /> NUMBER OF STORIES, (Not including basement) <br /> 31.3 2.01] b " � ( . <br /> AREA TO NEAREST SQUARE FOOT: <br /> S „rn . chment .- <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ' <br /> Erosion <br /> rt4.1 ,: <br /> BASEMENT: 1ST FLOOR: h � S� <br /> .�i <br /> 2,176.0 TOTAL SQUARE FOOTAGE: ` ; .' c��.t ��? ° '1:::,,,, <br /> 2ND FLOOR: 3RD FLOOR: asw .' <br /> 740.0 5,092.0 _' ' <br /> C teview .os>n°Surrey': <br /> ESTIMATED CONSTRUCTION COST: -+ - - - -4 �b �p (pns <br /> (Please round to nearest dollar) 432.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑✓Yes ❑No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ❑No Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓Yes <br /> ENO <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑✓1'es ❑No <br /> 5. Is this project associated with arezone/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 ONo <br /> 20 1-9 8,6' APPLICAS BE SIGNED <br /> 545-112(4/08) <br />