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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 /> BILL & DIANE CALLAHAN ❑zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 355 East Raylots Riverton Illinois 62561 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (217)306-5091 badbill56@yahoo.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> MITCH SPRECHER SPRECHER CUSTOM HOMES ❑ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 7594 SPRUCE VALLEY DRIVE 7594 SPRUCE VALLEY DRIVE <br /> (City,State,Zip) (City,State,Zip) ri Setbacks <br /> VERONA WI 53593 VERONA WI 53593 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 225-6524 (608) 225-6524 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MCSPRECHER@GMAIL.COM MCSPRECHER@GMAIL.COM ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ONING: ACREAGE: <br /> ❑PARCEL 0510-093-8680-0 TA-f AG 29.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> RUTLAND 9 1/4: Nw 1/4: SW ❑ Driveway permits <br /> ADDRESS: (state, county,town) <br /> U ;r SUNRISE RD OREGON WI <br /> CSM: LOT SUBDIVISION BLOCK/LOT n Sanitary permits <br /> 15,319 2 (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> NEW HOME ❑ Zoning District <br /> . nThis project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: LI Rural Address <br /> ESEWER 7EPTIC 13,202,100,155 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 23.2 1.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: p ❑ ErosionControl permit <br /> 2,350.0 3,780.0 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ► ► and available options. <br /> ♦ ♦ - - <br /> (Please round to nearest dollar) $ 425,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ZNo (Don't know <br /> 2. Is there a wetland or floodplain on or near the property? nYes 17No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓Yes END <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? T]Yes ❑✓No <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) DYes ❑No DDon't know <br /> 7. Is this to correct a violation? ❑Yes ❑✓No <br /> ti <br /> /^ 3 APPLICATION MUST BE SIGNED <br /> REV(01/19) i F (r. (Continue on Back) —0 —► -+ <br />