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DANE COUNTY Zoning Division <br /> •�'; ' ,� PLANNING DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> con =- <br /> Madison, Wisconsin 53703-3342 <br /> FloodFloodplain Development Application Phone: (608) 266-4266 <br /> p p pp Fax: (608) 267-1540 <br /> Items required to be submitted with application: <br /> o Site Development Plans <br /> Plans shall include scaled drawings of existing topography of the area and proposed final grades of <br /> development. All topographical information shall be in NAVD 1988 and be referenced to a known <br /> benchmark. The plan shall show all existing and proposed building footprints and elevations of lowest <br /> floor elevations. The plans shall include dimensions of ditches, culverts, or other structures existing or <br /> proposed. All plans shall be stamped and signed by a professional engineer or architect. <br /> o Engineering Analysis <br /> The analysis shall include calculations or modeling that shows that the development will not obstruct <br /> flow or will not increase the floodwater elevation 0.01 of a foot or more. All calculations shall be <br /> stamped and signed by a professional engineer or architect. <br /> Owners Name Contractor's Name <br /> Address /4 g 2. C. Q aQ 8 Address l�� C y- AV rj <br /> D.e4 tee.P/ �T� s 3,—3 1 oQQ/1 h n <br /> / <br /> Phone Phone <br /> Go&- (13g ' 3z $ 3 Zug . 3ce • e9 iY <br /> Email /) 6 Email �.f {� � ,sue iC�wQ.CcTr� <br /> C� getr rN/� C.dti"- e"eS���4- v <br /> t/ <br /> Parcel numbers affected: cal J/ - /31 —SS co-4 Town: Co Abase. Gov c- Section: / <br /> Property Address: S � <br /> FEMA Panel Map: 14-s )4 Floodplain District: Z0'--e A Flood Elevation:No ts�o��•sie()!', <br /> Scope of work: (Describe development)in detail) A1, '' - L i� ,+ . /J .1)• <br /> emit �'� -dam' p !o,i, r t' s, i•v 0.^!C <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: Date: <br />