Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> l <br /> PROPERTY OWNER INFORMATION CUS OMER TO PROVIDE <br /> OWNER NAME <br /> David Savoy <br /> lil orr)6ng Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Died Restriction; CSM <br /> 963 Johnson Ave Oregon, WI <br /> jt <br /> / lance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)209-8853 dsavoy @tds.net o Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION nd includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Scott Foley Ultimate Construction, Inc ite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 4827 Pierceville Rd 4827 Pierceville Rd <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Cottage Grove, WI 53527 Cottage Grove, WI 53527 <br /> PHONE PHONE ❑ It Plan wrnsoyhl from <br /> (608) 825-4633 (608) 825-4633 apPlic e toa <br /> E-MAIL ADDRESS p. <br /> E-MAIL E-MAILADDRESS , <br /> office @ultimate-construction.com office @ultimate-construction.com Ioor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) 'Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p rty <br /> IN PARCEL 042/0509-134-0168-0 R-1 DCPREZ-0000-02209 frontage drawn to_pEiTe. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Oregon i3 1/4: .S r 11/4: Jk) i1 ❑Drivewa er�mits P <br /> ADDRESS: <br /> stat ounty,town) <br /> 963 Johnson Ave ►r <br /> Sanitary permits Ili' \A\ <br /> CSM: LOT 1 Q SUBDIVISION BLOCK/LOT (public, private) <br /> v Oregon Territory <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: <br /> Room and Garage Addition a �— <br /> . ❑This project is a new building or structure. P- t <br /> tg This project is an addition/alteration to an existing building or stru. ure. � ,N--,,,--,..7-3„3 <br /> SANITARY SERVICE: PERMI UMBER: MOW=� re, P t-e I°',!` <br /> / <br /> II-EWER Eg•EPTIC / <br /> d ° <br /> S'% c r <br /> HEIGHT IN FEET: NUMBER• "ORI S: (Not including basemen 's <br /> 16.0 1.0 '` " ' > t . <br /> ' `°-1 6: Per <br /> AREA TO NEAREST SQUARE FOOT: '- � <br /> (Outsid y«.•-',q '• luding unfinished ar--, = fie• I: -ges and above grade decks or porches) -4 , <br /> BASE-ENT R: $. ,5.'' 0 it m-1 ,)a s.,“242.0 miir 706.0 4, TOTAL SQUARE FOOTAGE: ,, {r,'tY e,, - i i�. . <br /> 2ND FLs— 3RD FL••_. <br /> $ '' <br /> 948.0 ` <br /> s�s+- s y <br /> ESTIMATED CONSTRUCTION COST: a ^�P8 tt9 . x <br /> (Please round to nearest dollar) ♦ —' ♦ '' ♦ —' $ 110 000.00 gk <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? [Yes EN ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes ✓ o <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# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Eyes ❑No Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓❑No <br /> i - 0 APPLICATION MUST BE SIGNED <br /> 1� 1 j (Continue on Back) —0 —► —0 <br /> 545-112(4/08) <br />