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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 /> Heffron Company ❑Zonin St us; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed a triction; CSM <br /> 2000 Prairie Street,Prairie du Sac,WI 53578 Varian (# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)643-8525 heff@heffronhomes.com ❑Site Plan d n to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and in u es dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dan Heffron,Jr. Heffron Homes,Inc. 0 Site Plan in uding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/ a Ic <br /> 2000 Prairie Street 2000 Prairie Street <br /> (City,State,Zip) (City,State,Zip) 0 Se4ks <br /> Prairie du Sac,WI 53578 Prairie du Sac WI 53578 <br /> PHONE PHONE ❑Site Pia, a•41 .I from <br /> (608) 644-3911 (608) 644-3911 applica, I: o`� ship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> heff@heffronhomes.com heff@heffronhomes.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACRE/ E' <br /> ElPARCEL 050/0907-184-4628_n t eb i ( frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Roxbury +/4: 1/4: ❑ Drivew y ermits <br /> ADDRE (state, unty,town) <br /> Jenny Lind Lane <br /> ❑Sanitary permits <br /> CSM: LOT 38 SUBDIVISION BLOCK/LOT (public, • =� ') <br /> V Blackhawk Fields 36. r''VWI <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW \ <br /> PROJECT DESCRIPTION: <br /> Single Family Residence with Attached Garage ❑ Zoning Vstrict <br /> . ❑✓ This project is a new building or structure. ❑ Permit/Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ R ral Address <br /> EWER rEPTIC nev(existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> e-eairt, 7.Dr 1.0 ❑ Wetland/FIQo plain/ <br /> AREA TO NEAREST SQUARE FOOT: Shorelal ;/( chment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ ErosionControl permit <br /> BASEMENT: 1 ,863.0 1ST FLOOR: 2,836.0 ,, TOTAL SQUARE FOOTAGE: ,, (slope turbance, <br /> filling/ ess) <br /> 2ND FLOOR: 3RD FLOOR: (��j <br /> ``o`'M ❑ Revi w �cet" n Survey <br /> ESTIMATED CONSTRUCTION COST: and av4l bl o tions. <br /> (Please round to nearest dollar) ♦ -+ ♦ $ 400,000.00 ..- <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑✓No ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? Efres allo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? rYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? fres ❑✓No <br /> 5. Is this project associated with a rezone/CUP ri..•- (petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) . •..vir 1" ... ✓ es ENo Don't know <br /> 7. Is this to correct a violation? ❑Yes [TIN() <br /> APPLICATION MUST BE SIGNED <br /> REV(01/19) (Continue on Back) -► - -► <br />