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Town of Springdale. Dane( ount:s.Wiscomin <br /> -2319 Iowa Ilan Rd. \It !torch.wt 4448)437-42.30 tow iiatyrtneelalr a NI tilt",liei <br /> ACCESSORY BUILDING(AB)PERMIT APPLICATION: RESIDENTIAL OR AGRICULTURAL <br /> (Thu i perm*,dove,not reptscrbikcr retulaton permits mhich tos he requin-d.QueitivnI7 Sec al-mire(numbers Wan.) <br /> Owner(t)Name r--uci-vt elta-101re.1 ch.c.c,,i at Phone - -2.3/ <br /> Imuil -SATICe ArVO:ii. Com Site Address 2219 baktif- C-excia- e rt4A. 5 3 11 <br /> Existing Accessory Building(s)(xt property (detached garage,outbuilding.agricultural.etc.r. <br /> List: Li+i I 1.-11-1 - tv bt evtediect u Sect; e_ I ;•F 'Acttt-tvytts0k.44 <br /> ero af.2.Wt <br /> Total square footage of existing accessory building(*)on proper1y jq square feet <br /> Proposed Accessory Building Location of AS is within the Town-approved building envelope: Yesi_D° <br /> Project Access: <br /> Existing driveway will provide access to the accessory building: fNo <br /> If no,has new driveway permit been granted to access the new building: Yes/No <br /> iSo. ek.wle,',v2 <br /> Retailed I'se of Building fling Altricultural 0 or Residential ' <br /> 1)imensions I. 5(0 Total Square Floor Footage (Deo #of Stories I <br /> Foundation(Circle) Masonry Treated Wood Other <br /> 11 VAC:0.30"No Electrical:, silNo V4'ater:( es),4N0 <br /> Other information? fet if +15;lee+ '4" ,c164g- P°4"ta'A- CU:flx"- <br /> A complete application for an Accessory Building permit most include the following documents and must be <br /> sOnitted to the'Fown Clerk before an AB permit will be reviewed or any related public meetings arc held. <br /> Al Site plan showing the location and size of the proposed AB and all other structures on the lot, including the well <br /> and septic. Aerial images can be created/printed thru accessdane.couni,vofdanc.cum or contact the Town Clerk. <br /> Cl Completed Driveway Inspection Report and Permit(if applicable). <br /> 1 agree to comply with all the applicable codes, statutes, ordinances, and with the conditions of this permit. I <br /> understand that the issuance of the permit creates no legal liability, express or implied,on the state or municipality. No <br /> development agaecments, covenant restrictions and/or other legal documents exist which would prohibit the <br /> construction of the AB.I certify that all the above information is accurate. It is understood that the AB shall not be used <br /> for habitation and/or business purposes.The AB shall not be occupied as a residence:no guest houses or apartments are <br /> allowed in the AB. I expressly grant the building inspector.or the inspector's authorized agent, permission to enter the <br /> premises for which this permit is sought at all reasonable hours and for any proper purpose to inspect the work which is <br /> tieing done <br /> Applicant's Signature <br /> Date Signed <br /> 51;2.(2_t <br /> After approval of the AB by the T n,the following documents, when applicable, must he submitted to the I ossn <br /> Building Inspector(Johnson Inspections,LLC 608-444-0372)before the Building Permit will be issued. <br /> Cl County Erosion Control Plan for the building site Contact 608-244-3730 <br /> 0 County Zoning Permit for building Contact 608-266-4266 <br /> 0 Wisconsin AdministrativeBuilding Permit Application Contact 608444-0372 <br /> 0 Dane County Enviroruncrital Health Contact 608-242-6515 <br /> Cl Wisconsin Department of Natural Resources Contact 608-266-2621 <br /> Fee$10000 - Paid 1,...141." ereviou.r 912.0iit <br /> — <br /> Town's Approval Chair Signature: s% t,,:, <br /> Date <br /> Conditions: F014 c‘rk <br />