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,I,te,, Lk,c.`73 t I <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> david and marjorie bien <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 7686 welcome drive verona,wi 53593 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)239-4232 dave.bien @subzero.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> darren johnson comfort builders Ilc ❑Site Plan including location �) <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic T 5ed.�0 <br /> 7267 squire cir S <br /> (City,State,Zip) (City,State,Zip) El Setbacks I 5a Jr0/ <br /> middleton,wi 53562 "Gat r c r <br /> PHONE PHONE ❑Site PI . ival from <br /> (608) 836-8797 apple e ip "F <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dsjohnson999 @gmail.com El Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) . <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ,❑Elevation of property `"L"'1 t <br /> ❑PARCEL 1.50 *. frontage drawn to scale. I--+ <br /> NUMBER / <br /> TOWNSHIP: SECTION: <br /> 1/4: '/a'/4: ❑Driveway permits pOLU5� <br /> ADDRESS: (state, county,town) <br /> 7686 welcome drive <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> • <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION ' 4 <br /> PROJECT DESCRIPTION: ` 4 '' ` <br /> 7 Z�nttg[ istrict <br /> O This project is a new building or structure. <br /> ., P ratted U 47 <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: RuralAddres <br /> EWER FIEP I1 't li t i <br /> HEIGHT IN FEET ?��" S NUMBER OF STORIES (Not including basement) " 1 <br /> 1 .0 iyetvI/) 1.0 � + )3IBl tf <br /> AREA TO NEAREST SQUARE FOOT: 441 (40G�#1t <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: I -,_:::-4,:1„,rt lonC;vrftt©)p t� ,za <br /> 308.0 ,, TOTAL SQUARE FOOTAGE: +, = ,d : <br /> 2ND FLOOR: 3RD FLOOR: ' *,� ' <br /> 308.0 _ , <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ � wit <br /> (Please round to nearest dollar) $ 8,000.00 ;-,, ;• <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dies ENo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres Elo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? res ❑'lo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Efres lab <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) Efres JVo ElDon't know <br /> 7. Is this to correct a violation? ❑Yes ✓7lo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(aros) (Continue on Back) —1 -+ -♦ <br />