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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 /> Richard H Kranze <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1704 N Fernandez Ave Arlington Heights IL 60004 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (847)962-5440 rkranze @kranzetech.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Bouril Design Studio,c/o Robert Lackore Encore Homes Inc,c/o Tracy Wimer ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 6425 Odana Rd Ste 2 6480 Schneider Rd <br /> (City,State.Zip) (City,State,Zip) ❑Setbacks <br /> Madison WI 53719 Middleton WI 53562 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 833-3400 (608) 836-9601 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> robl @bourildesign.com twimer @encorebuilds.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:/laccessdane.co.dane.wl.usn <br /> PARENT i PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑PARCEL I 028/0610-133-9260-5 R-3 Residence 0.30 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Dunn 13 1A. SW +1h: SW p Driveway permits <br /> ADDRESS. ----- (state, county,town) <br /> 3423 Stoney Crest Rd McFarland WI 53558 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> prt gov lot 2 (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Tear-down existing single-family home and construct a new single-family home. ❑ Zoning District <br /> MI This project is a new building or structure. <br /> CI Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE. PERMIT NUMBER: ii Rural Address <br /> EWER rEPTIC 623 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 27' (mean of roof) at street elev 2.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ ErosionControl permit <br /> IASEMENT: 1ST FLOOR: <br /> 3,132.0 3,162.0 4 TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 2,822.0 9,116.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: —* —* ♦ ♦ .♦ $ 1 ,037,120.00 and available options. <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies ['No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes rgNo ODon'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 /51No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# U ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Dies ENo ❑Don't know <br /> 7 Is this to correct a violation? ❑Yes ONo <br /> APPLICATION MUST BE SIGNED <br /> 645.112(OW (Continue on Back) <br />