Laserfiche WebLink
CONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME PETE RAULS <br /> Q Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6479 HARVEST MOON CT, WAUNAKEE,WI 53597 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)556-6413 PETERAULS @GMAIL.COM 0 Site Plan drawn to scale <br /> CONTRACTOR INFORMATION and includes dimensions <br /> AGENT INFORMATION CONTRACTOR NAME CONTR <br /> AGENT NAME 0 Site Plan including location <br /> AGENT ADDRESS <br /> CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) <br /> (City,State,Zip) ❑Setbacks <br /> Site Plan approval from <br /> PHONE PHONE applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.whus/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: frontage drawn to scale. <br /> 0 PARCEL 064/0909-363-2220-0 R-1 DCPREZ-0000-08676 0.40 <br /> NUMBER SECTION: <br /> TOWNSHIP: Driveway permits <br /> 14'�4 <br /> TOWN OF VIENNA '4 ' (state,county,town) <br /> ADDRESS: 6479 HARVEST MOON CT <br /> Sanitary permits <br /> CSM: <br /> LOT SUBDIVISION BLOCK/LOT (public,private) <br /> NATURE VALLEY CONSERVANCY <br /> PROPOSED PROJECT INFORMATION <br /> STAFF REVIEW <br /> PROJECT DESCRIPTION: 1=1 ZOning District <br /> PERGOLA ON PATIO <br /> . 51 This project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. CI Rural Address <br /> SANITARY SERVICE PERMIT NUMBER: Rural Address <br /> FIEWER �EPTIC <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) ❑ Wetland/Floodplain/ <br /> 10.0 Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ ErosionCdntrol permit <br /> BASEMENT: 1ST FLOOR: <br /> 4, TOTAL SQUARE FOOTAGE: IF (slopes,disturbance, <br /> p filling/access) <br /> 2ND FLOOR: 3RD FLOOR: 168. 0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ --► <br /> 1 ,200.00 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? ['Yes QNo QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? <br /> [Yes 2No QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? flYes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes 12 No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none)(Yes ONo ❑Don't know <br /> 6. Is a location survey required? (see reverse) �Ive8 �No <br /> 7. Is this to correct a violation? IIJJ <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ♦ -♦ <br /> 545-112(4/08) <br />