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F!Q <br /> 0 � <br /> DANE COUNTY Zoning Division <br /> • '; �� PLANNING DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. j <br /> 8os�`= Madison, Wisconsin 53703-3342 <br /> Floodplain Development A pp lication Phone: (608) 266-4266 <br /> 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 O <br /> _ t.)- ("teS- <br /> Address 5 7A/ ia, A h Address t <br /> Phone LOA-two-Yom) 1.3 I 6 3 S!O 7 Phone t o <br /> Email Email <br /> • _ • - • t• • <br /> Parcel numbers affected: 0.3o q_a// - // – Town: 1,e v.i- Section: <br /> Property Address: `S •` <br /> 1A-Doa.ma_ , ,9 5-3 S9 <br /> FEMA Panel Map: - - / f'1 Floodplain District: A 6 '4/�tyFlood Elevation: �6a 9 <br /> Scope of work: (Describe development in detail) o 6._C2 airlotl 0. ) Q rE_Md0/ Y� <br /> / " a sz3 01 it.rvimocZA 4o ,+ .0 244 �c 4 n� �; <br /> 3 I� IroG�C q ��,, .�Z bm—Ps-� <br /> U <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 />