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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 /> Brian McFarland and Emily McFarland <br /> n Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6474 York Heights Rd.Waterloo,WI 53594 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (920)222-2677 (920)222-2677 brianmcfarland02@gmail.com ❑✓ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> ❑✓ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> (City,State,Zip) (City,State,Zip) ❑✓ Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> C Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dnne.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑✓ Elevation of property <br /> 71 PARCEL 070/0912-361-9340-2 RR-4 4.25 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of York y,; th; n Driveway permits <br /> ADDRESS: (state,county,town) <br /> 6474 York Heights Rd. Waterloo, WI 53594 <br /> CSM: LOT <br /> LOT 1 SUBDIVISION BLOCK/LOT ❑✓ Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> 2nd garage detached 30' X 40' R.A.B. 0 Zoning District <br /> • ❑✓ This project is a new building or structure. 4/Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 0 Rural Address EX <br /> EWER V)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not Including basement) 0 Wetland/Floodplain/ <br /> NO <br /> 16.5 mean Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: sr FLOOR: IV ErosionControl permit <br /> 1 ,200.0 4 TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, NO <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 1 ,200.0 <br /> c/Review Location Survey YES <br /> ESTIMATED CONSTRUCTION COST: --► and available options. <br /> (Please round to nearest dollar) -4 $ 30,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑✓No fDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Elves ENo nDon'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? nYes 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) nYes ❑No ['Don't know <br /> 7. Is this to correct a violation? Des CNo <br /> $170.00 APPLICATION MUST BE SIGNED <br /> (Continue on Back) -0. -I• -+ <br /> REV(01/19) <br />