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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 Kittleson <br /> _ __ n Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 201 Taylor Lane Stoughton,WI 53589 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)438-1552 briankittleson@icloud.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jay SOUTHERN OUTDOOR SUPPLY ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 336 River End Lane <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Mount Airy,NC 27030 <br /> PHONE PHONE <br /> 800 447-8161 Site Plan approval from <br /> ( ) (336) 755-2260 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> southernoutdoorsupplyOyahoo.corn southernoutdoorsupply@yahoo.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT <br /> El PARCEL <br /> NUMBER PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> 026/0511-322-8350-0 RR-2 2.20 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Dunkirk 32 %/4: NE �/4: NW ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 201 Taylor Lane <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 9,755 2 (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Detached Garage for Storage ❑ Zoning District <br /> E This project is a new building or structure. <br /> Li Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: Li Rural Address <br /> EWER r)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF Si ORIES: (Not including basement) <br /> 12.0 <br /> AREA TO NEAREST SQUARE FOOT: 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT 1ST FLOOR: ❑ ErosionControl permit <br /> 450.0 j TOTAL SQUARE FOOTAGE: + (slopes, disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 450.0 <br /> Li Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ –0.. ♦ ♦ Q and available options. <br /> (Please round to nearest dollar) .p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes ❑No ['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? [fres ❑✓No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑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) [fres QNo ❑Don't know <br /> 7. Is this to correct a violation? Des ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> REV(01/19) (Continue on Back) -► ♦ — <br />