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ZONNG pERivrr APPLICATION wiwecounitycida1acom SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Timothy & Kathleen Wilson <br /> Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1300 Garden Ave. Stoughton, WI 53589 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 608-698-2118 wilsn5 a,yahoo.com 'ite Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Timothy Wilson Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1300 Garden Ave. <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Stoughton, WI 53589 <br /> PHONE PHONE ite Plan approval from A/A <br /> 608-698-2118 applicable township. l" <br /> E-MAILADDRESS E-MAIL ADDRESS ,,-�,,� <br /> wilsn5(c�yahoo.com Laloor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn levation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p y <br /> WI PARCEL 052-0510-222-8660-7 RH1 3.21 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Rutland D '/4: N t)) IRA: N \ Driveway permits ),f p <br /> ADDRESS: C (state, county,town) <br /> 7 (, O A anitary permits ijk- <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: �, <br /> Detached Garage 3d X 3 tf Zoning District <br /> . 171This project is a new building or structure. EI Poermitted'Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: O.J Rural ' •• -- <br /> EWER EPTIC (ne exi <br /> P s mg) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) ,�/ <br /> ILI i n� 4" 1 tti1'Wetland loodplaiN on <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) u,.,"---- <br /> ErosionControl permit JO <br /> BASEMENT: 1ST FLOOR: /�V <br /> 1 t,a + TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: `O` aeD �/ <br /> lid FKeview Location Survey jQ <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ -+ -+ and available options. j <br /> (Please round to nearest dollar) 32000 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes JNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes JNo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Wfres ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dyes 171No <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 12:1No ❑Don't know <br /> 7. Is this to correct a violation? Elves IZINo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) —► —► -+ <br />