Laserfiche WebLink
SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Trisha and Aaren Christen <br /> Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) ❑ <br /> 1461 Berlin Rd, Marshall, WI 53559 Deed Restriction; CSM <br /> Variance(# <br /> HOME PHONE CELL PHONE E-MAILADDRESS <br /> (608) 712-3083 trishachristen@gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Wollin Builders ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 207 Talon PI <br /> (City,State,Zip) (City,State,Zip) El Setbacks <br /> Sun Prairie, WI 53590 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 513-0767 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> rckwollin@yahoo.com El Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accossdano.eo.dane.wi.us/) <br /> El Elevation of property <br /> PARENT PARCEL NUMBER: CURRE T N G: ACR G <br /> ❑PARCEL 081206295050 - 88 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP SECTION: <br /> • Medina 1/4: 1/4: ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> 1461 Berlin Rd <br /> Cm: LaT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 12347 (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> THREE SEASON PORCH, DECK, AND STEPS ❑ Zoning District <br /> . ['This project is a new building or structure. <br /> ❑ Permitted Use? <br /> ['This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: - ❑ Rural Address <br /> EWER PEPTIC (new/existing) <br /> HEIGHT IN FEET: NUM BER OF STORIES: (Not including basement) TO T-IE <br /> 26.0 1.0 ❑ Wetland/Floodplain/ SOU—Id <br /> Shoreland (attachmerF AJDN <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached ❑garages and above grade decks or porches) ErosionControl permit <br /> BASEMENT: 1ST FLOOR: 3-75 4 436 j TOTAL SQUARE FOOTAGE: j (slopes, disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 3-7&f} 436 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST and available options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ $ 36,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Efres 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? ['Yes ❑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 ['No ['Don't know <br /> 7. Is this to correct a violation? ❑Yes ['No <br /> $93.60 APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ ♦ -+ <br /> REV(01/19) <br />