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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Amy & Charles Frochtzweig oning Statue <br /> OWNER ADDRESS (Number,Street.City.State.Zip) <br /> Deed Restriction M <br /> 2277 Rinden Road,Cottage Grove,WI 53527 Variance(# � ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)839-6000 (608)219-2198 cdweldingco @gmail.com a Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dave Budden Meigs Inc-Dave Budden Site n including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS ell/septic <br /> P.O.Box 412 P.O.Box 412 <br /> (City,State,Zip) (City,State,Zip) tbacks <br /> Black Earth,WI 53515 Black Earth,WI 53515 <br /> PHONE PHONE ite Plan approval from <br /> (608) 767-2729 (608) 767-2729 applicable townshipCP <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com dave @meigsbuilds.com or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: El ion of property <br /> ❑PARCEL 046/0611-102-8001-5 A2 6.94 rontage drawn to scale. <br /> NUMBER 1 ISI'( ) <br /> TOWNSHIP: SECTION: L <br /> Pleasant Springs 10 1/4: NE 1/41/4: NW ❑Drive rmits _e,.r ' <br /> ADDRESS: (state unty,town) ((( <br /> 2277 Rinden Rd, Cottage Grove, WI 53527 i. <br /> CSM: LOT SUBDIVISION BLOCK/LOT anitary private S <br /> 8,699 (publ'-,private . <br /> PROPOSED PROJECT INFORMATION straw REVIEW <br /> PROJECT DESCRIPTION: <br /> NEW F4 frt u LI Ba 5MJe c f ctALTy 1,..)0c-1.)In S.-1i O P oning Dis 'GI <br /> IN This project is a new building or structure. P fitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER PEPTIC is- 2011 o040U (n existing <br /> HEIGHT IN FEET: I NUMBER OF STORIES: (Not includg basement) <br /> 2j 26 1 ❑ We - •.,' .-.,plain/ <br /> AREA TO NEAREST SQUARE FOOT: Sh•, attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR ❑ Erosio 0 0l permit <br /> TOTAL SQUARE FOOTAGE: j (slopes turbans, <br /> 2 co fillip acce <br /> 2ND FLOOR: 3RD FLOOR: <br /> 2s cb D ❑ Revi L on Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ -4. -+ ♦ and a i options. <br /> (Please round to nearest dollar) $ /So DO v \\/1/0 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes E 4 ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Y s ENo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [?es EIVo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Des Dliclo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# 11194 ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) ❑Yes is o ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes I: 4o <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545-112(4/08) <br />