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, ( <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Paul West gic;ning Status; CUP; <br /> OWNER ADDRESS (Number,Street City,State,Zip) <br /> Deed Restriction; CSM <br /> 1053 Taylor Ln Stoughton,WI Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)877-2556 paulraewest @chickenhollow.com ❑'Site 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 ite Plan approval from <br /> (608) 379-0132 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tleeser @clearybuilding.com lOor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENTZONING: ACREAGE: gli levation of property <br /> ❑PARCEL 026/0511-171-8550-0 A-2(1) 1.04 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Dunkirk 17 1/4: NW %IA: NE riveway permits f i 1 <br /> ADDRESS: (state,county,town) " <br /> 1053 Taylor Ln <br /> .ID-Sanitary permits A/ 4 <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public,private) <br /> PROPOSED PROJECT INFORMATIONor;# <br /> PROJECT DESCRIPTION: �_� <br /> 2400 sq ft accessory building s{©t-a Sy 4 +-3n X �e onin• isf �' o. <br /> . 4 This project is a new building or structu e. rrnitt .VietTtfftrft <br /> ❑This project is an addition/alteration to an existing building or structure. 4r1 0W <br /> L Yr,®! Ad•,, 3E3 1w. <br /> SANITARY SERVICE: PERMIT NUMBER: a <br /> 1�Y w�F; <br /> EWER rEPTIC (new! +s ) <br /> HEIGHT IN(FEET: I NUMBER OF STORIES: (Not including basement) ., oaf <br /> 1i ` 5 twit.(,. 20.0 1.0 ''etland/F(oodplairtl <br /> Shoreland (attach nt) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: oslOnG% • , <br /> j TOTAL SQUARE FOOTAGE: ,, (slopes)dls rba C <br /> 2ND FLOOR: 3RD FLOOR: filling/acces$05 �` °, <br /> � � €; <br /> 2,400.0 L` evrew too : <br /> cation Survey • <br /> ESTIMATED CONSTRUCTION COST: ' -arld available options <br /> (Please round to nearest dollar) ♦ ♦ ♦ —* —* $ 50,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes ONo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [—Yes 4No DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes 1g No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ONo <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 ig No ❑Don't know <br /> 7. Is this to correct a violation? nYes '4No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -+ -► <br /> 545-112(4/08) <br />