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to <br /> S <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENTtwa�wPP <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Virginia Link <br /> D Zoning Status; CUP; <br /> OWNERADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2102 CLIFF CT MADISON WI 53713 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)334-4535 ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cleary Building Corp ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 190 Paoli St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Verona,WI 53593 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 379-0132 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> tleeser@clearybuilding.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (httrollae00asdana oo.dana wi.uni) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑PARCEL 032/0709-351-7827-1 SFR-08 0.76 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Madison 35 /_ SE 1/41/4: NE 0 Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2102 CLIFF CT <br /> 0 Sanitary permits <br /> CSM: LOT 7 SUBDIVISION BLOCK/LOT (public, private) <br /> HAMMERSLEY HEIGHTS <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 440 sq ft detached garage,replacing existing 20' X 22' GARAGE, R.A.B. ❑ Zoning District <br /> ❑✓ This project is a new building or structure. ❑ Permitted Use? YES <br /> OThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER DEPTIC (new/existing) EX <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 11 .5 MEAN 12.8 1.0 ❑ Wetland/Floodplain/ N OO <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: <br /> 440 j TOTAL SQUARE FOOTAGE: j (slopes,disturbance, NO <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 440.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ and available options. YES <br /> (Please round to nearest dollar) ♦ ♦ $ 30,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes Do ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes No ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ONo <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) YES EYes ONo ['Don't know <br /> 7. Is this to correct a violation? DYes ❑✓No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ♦ —10 <br /> 545-112(4/08) <br />