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.$.1 4Z. <br /> FZE:= <br /> ZONING PERMIT APPLICATION www.count■ ofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Brad Gustrowsky Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2260 Liatris Ln McFarland,WI Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)772-3025 aSlfe Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cleary Building Corp Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) etbacks <br /> Verona,WI <br /> PHONE PHONE _ e Plan approval from <br /> (608) 379'0132 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tleeser @clearybuilding.com loot plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:/laccessdane.co.dane.wi.us/) e�vatlon of ro ert <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: EE`-' p P Y <br /> PARCEL 028/0610-211-9810-4 A-1EX 737 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Dunn 21 /4; SE 1/41/4: NE nveway permits t r <br /> ADDRESS: (state,county,town) ,lv <br /> 2260 Liatris Ln <br /> D-Saiiitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT N <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION . <br /> a <br /> PROJECT DESCRIPTION: / <br /> f <br /> 2560 sq ft Farm Storage shed )( d �' IIIK!! �"1t�? tz <br /> NI This project is a new building or structure. <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: t °& � <br /> y// `+ tii ) <br /> EWER F1EPTIC 1 �p <br /> HEIGHT IN FEET: � NUMBER OF STORIES: (Not induding basement) , ; <br /> : h ) :a.i t41.@ti a W. <br /> t '' loC0�22.3 1.0 ; iia � e L9 Nurt� <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) = r <br /> o ' i e ,- <br /> BASEMENT: 1ST FLOOR: �a1 <br /> 4, TOTAL SQUARE FOOTAGE: 4, ; ' °° .,..511%.:1: e.. :4 k� � ° <br /> 2ND FLOOR: 3RD FLOOR x <br /> 2,560.0 . .t1 <br /> e <br /> ESTIMATED CONSTRUCTION COST: f e •a <br /> - -� � � � -+ $ ons ,-'= <br /> (Please round to nearest dollar) _ 4•� <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes No nDon't know <br /> Q '4 <br /> 2. Is there a wetland or floodplain on or near the property? QYes jNo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? ['Yes IgiNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ['Yes '4No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# n) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) QYes No ['Don't know <br /> 7. Is this to correct a violation? ['Yes Q✓No <br /> AIAUS BED <br /> (Continue PPL C on TION Back)MT —E►SIGN—► —► <br /> 545-112(4/08) <br />