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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 /> Nathan D. Sperloen Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 30 West Mifflin Street Ste404-Madison, WI. 53703 Variance(# 01L 02f 121 r <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)217-5954 nsperloen @remachines.com igi Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Brad Cheske RA Pinno Construction-Pinno Buildings to Plan including location A <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic Nv t,..k/ ,, ,` <br /> 5540 State Rd 50 Ste 102 5540 State Rd 50 Ste 102 Sicktrer <br /> (City,State,Zip) (City,State,Zip) 4 Setbacks 6r- <br /> Delavan,WI. 53115 Delavan, WI. 53115 <br /> PHONE PHONE [].Site Plan approval from A <br /> (608) 295-5141 (608) 295-5141 applicable township. T <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> bradc @rapinno.com bradc @rapinno.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) vation of property <br /> PARENT PARCEL NUMBER: CURRENTZONING: ACREAGE: <br /> ❑NUMBER 032/0709-351-0950-5 R3 1 . 35''1 frontage drawn to scale. <br /> TOWNSHIP: SECTION. d <br /> Town of Madison ) j 1/4: QE— '/<'/a: l} ' ‘way permits JA. <br /> ADDRESS: (state,county,town) <br /> M --. -ry permits N4 <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (publi private) <br /> PROPOSED PROJECT INFORMATION e + t ° ; <br /> PROJECT DESCRIPTION: "` ,1, �a1 <br /> Construction of New Residence with attached garage ...�.._ • _,• „ "r '> -. <br /> . ri This project is a new building or structure. .,;1•:'':,... , 1 <br /> ❑This project is an addition/alteration to an existing building or structure. .. :s,"- � -efr <br /> SANITARY SERVICE: PERMIT NUMBER: ,w` y„,-,.t '+ <br /> EER r)EPTIC " <br /> �. i • � <br /> W <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not J � including basement) * <br /> yLCY� A : t. +'ti" �� <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) D§ •i ',.::;;',14 <br /> BASEMENT: 1ST FLOOR: '• • '. } $ a w' t <br /> 2,432.0 3,392.0 + TOTAL SQUARE FOOTAGE: 4, <br /> 2ND FLOOR: 3RD FLOOR: . . `, g,.F , 4 /C <br /> 5,824.0 �, x <br /> s r P <br /> ESTIMATED CONSTRUCTION COST: j.• „ ! , ,. , fti-,' <br /> (Please round to nearest dollar) --► - -• -• -• $ 360,000.00 a„ _: -t ;ir .t„„4 <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? Efres ElNo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? /Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓❑No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) , blank if none) <br /> 6. Is a location survey required? (see reverse) 4i��r . • ❑Don't know <br /> 7. Is this to correct a violation? Yes IN o <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -+ <br /> 545-112(4/08) <br />