Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> David & Rebecca Quick <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Orling Status; CUP; <br /> 7584 Lokken Lane, Verona, WI, 53593 Deed Restriction; CSM <br /> HOME PHONE 'CELL PHONE Variance(# ) <br /> E-MAIL ADDRESS -- <br /> (608) 220-4233 beckyquick6@gmail.com Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jason Thomas Homes LLC Jason Kratochwill Q'Site Plan including location / <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 7521 Hubbard Ave 7521 Hubbard Ave <br /> (City,State,Zip) (City,State,Zip) ;Setbacks <br /> Middleton WI 53562 Middleton WI 53562 , <br /> PHONE PHONE O Site Plan approval from <br /> (608) 220-6391 (608) 220-6391 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jason@jasonthomashomes.com jason@jasonthomashomes.com I or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CU RENT2NIN ACREAGE: evation of property <br /> O PARCEL 060703488700 'J frontage <br /> NUMBER Pf '_33--6 r g drawn to scale. <br /> TOWNSHIP: SECTION: 1J ✓V <br /> Springdale 1/4. SC4. riveway permits <br /> ADDRESS: <br /> (state,county, town) <br /> pc ltd Bakken Rd <br /> CSM: LOT Q Sanitary permits <br /> fi, > (� SUBDIVISION BLOCK/LOT <br /> I ( 1 (public, private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: , i / STAFF REVIEW <br /> Single Family new construction \!\J / C 0 \ c ,)(.) rc y I ® Zoning District <br /> O✓ This project is a new building or structure. f <br /> N Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER. D Rural Address <br /> EWER {EPTIC /3 * z oZ I —000( 5 6w/existing) <br /> HEIGHT IN FEET: NUMBER Ur I DRIES: (Not including basement) <br /> M. O / 1.0 ❑ Wetland/Flo6d <br /> � 7plain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT:�O�� 1ST FLOOR: ❑ ErosionCOntrolpermit • <br /> L ' 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance,. <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> S574, ` Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ -► ♦ —o. <br /> and available options. <br /> (Please round to nearest dollar) /// (i%t� p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Ores , to ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes ,. o ODon't know <br /> 3. Have you talked with the township about your project and are they in agreement? aes ONo Y ss.a.c-.P <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes EjsJo `e~i=-4/......„e„.1 <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) .ales alo ODon't know <br /> 7. Is this to correct a violation? ❑Yesco <br /> ' 0 <br /> 4 69 0? . <br /> APPLICATION MUST BE SIGNED <br /> REV k01'19) (Continue on Back) —4. —+ -+ <br />