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;;x,0,09 DANE COUNTY roAd_ ?�,f 6 5 �I ~ t2- 1 <br /> i <br /> .,° ZONING PERMIT APPLICATION WWW.DANECOUNTYPLANNING.COM <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Gary Gar Nolden <br /> V J Nolden <br /> ❑Zoning Status. P; <br /> OWNER ADDRESS (Number,Street.City,State,Zip) Deed Re tr' ion; CSM <br /> 204 Brooke Dr. Belleville, WI 53508 Variance ) <br /> HOME PHONE !CELL PHONE E-MAIL ADDRESS <br /> (608)698-0259 gsnolden @gmail.com El Site PI drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and i ludes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> James Nolden James Nolden _ _ 0 Site P a cluding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of we eptic <br /> 577 West Church St. 577 West Church St. <br /> (City,State,Zip) (City,State.Zip) Ej SEVAt<s <br /> Belleville, WI 53508 Belleville, WI 53508 <br /> PHONE PHONE ❑Site Plal a val from <br /> E-MAIL ADDRESS (608) 513-4300 (608) 513-4300 _ applica lghip. <br /> E-MAIL ADDRESS <br /> noldenconstruction @yahoo.com noldenconstruction @yahoo.com ❑Floor p Vscale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> ElPARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: n Elevatl n o roperty <br /> PARCEL d RR-4 5.04 fronts awn to scale. <br /> NUMBER Dy IoSOg-Mt-(oo/1-0 I g <br /> TOWNSHIP: SECTION: <br /> Montrose 19 1/4: SE 1/4: NW ❑Driveway per its <br /> (state, C town)6' , A/ R.4 <br /> _ ❑Sa ' --r its <br /> CSM. 16,103 (LOT 1 SUBDIVISION BLOCK/LOT (pu 4,61%4A, IIMN <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New home - 1724 sq ft ❑ Zoning trict <br /> 0 This project is a new building or structure. ❑ Permit d Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: U Rural Address <br /> EWER 0-EPTIC 13 -Zozz. -oo3z2 xisting) <br /> HEIGHT IN FEET: �� O NUMBER OF STORIES: (Not including basement) ❑ <br /> 2.0 Wetland/ l0 cu/ <br /> AREA TO NEAREST SQUARE FOOT: — Shorela d hment} <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionControl permit 1 <br /> 1,272 2,396 , TOTAL SQUARE FOOTAGE: j, (slope d s ban l ,1 • <br /> 2ND FLOOR: 3RD FLOOR: filling/ * ■ <br /> 570 I 4,238 •'y `� <br /> ❑ Revi w tion Survey <br /> ESTIMATED CONSTRUCTION COST: and il�options. <br /> (Please round to nearest dollar) ♦ -♦ -♦ '♦ ♦ $ 450,000 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ... [ Yes Elio [,Don't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes 1: No [Don't know <br /> 3. Have you talked with the township about your project and are they in agreement Efres EJNo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? fYes fNo <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 ✓[Jlo ODon't know <br /> 7. Is this to correct a violation? eyes ✓ilo <br /> + — \N)1 ` 0 W7$ b& APPLICATION MUST BE SIGNED <br /> REV(01/t 9) �I (Continue on Back) --t. --► —► <br /> gi g4 0 30 1 <br />