TION httpaccessdaneTION httpaccessdaneTION httpaccessdaneTION httpaccessdaneTION httpaccessdane OWNER NAME OWNER ADDRESS Number Street City State Zip HOME PHONE CELL PHON ID: 872064
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1 !! ZONING PERMIT APPLICATIONwww.countyof
!! ZONING PERMIT APPLICATIONwww.countyofdane.com TION (http://accessdaneTION (http://accessdaneTION (http://accessdaneTION (http://accessdaneTION (http://accessdane OWNER NAME OWNER ADDRESS (Number, Street, City, State, Zip) HOME PHONE CELL PHONEPARENTPARCEL SUPPLEMENT to SUPPLEMENT to SUPPLEMENT to SUPPLEMENT to SUPPLEMENT to WWWWWeeeeeb-Ab-Ab-Ab-App #pp #pp #pp #pp # AAAAAGENT INFORMAGENT INFORMAGENT INFORMAGENT INFORMAGENT INFORMATIONTIONTIONTIONTION AGENT ADDRESS(City, State, Zip)E-MAIL ADDRESS E-MAIL ADDRESS CONTRACTOR NAMECONTRACTOR ADDRESS(City, State, Zip)E-MAIL ADDRESS PARCEL NUMBER:CURRENT ZONING: ________ ¼:________ ¼¼:________TOWNSHIP: LOTSUBDIVISIONBLOCK/LOT PRPRPRPROPOSED PROPOSED PROPOSED PROPOSED PROPOSED PROJECT INFORMAOJECT INFORMAOJECT INFORMAOJECT INFORMATIONTIONTIONTIONTION This project is a new building or structure. This project is an addition/alteration to an existing building or structure. SANITARY SERVICE: PERMIT NUMBER: HEIGHT IN FEET:NUMBER OF STORIES: (Not including basement)AREA TO NEAREST SQUARE FOOT:(Outside dimensions including unfinished area, attached garages and above grade decks or porches) Zoning Status; CUP;Variance (#___________)Elevation of propertyfrontage drawn to scale.Driveway permits(state, county, town)Sanitary permits BASEMENT:TOTAL SQUARE FOOTAGE: ESTIMATED CONSTRUCTION COST: "" 1.The property is within 300 feet of a stream or 1000 feet from a pond or lake?...........2.Is there a wetland or flood3.Have you talked with the township about your project and are they in agreement?....4.Has there been a zoning permit issued for this property in the past 5 years?.............5.Is this project associated with a rezone/CUP/variance (petition/appeal #_________)6.Is a location survey required? (see reverse)..............................................................7.Is this to violation?.......................................................................................YesYesYesYes(leave blank if none)YesYesCUSTOMER TO PROVIDE APPLICATION MUST BE SIGNED545-112 (4/08) Wetland/Floodplain/Shoreland (attachment)(slopes, disturbance,STAFF REVIEW 1.I, the undersigned, hereby make application for a zoning permit only for the location and the work described herein andcertify to the accuracy of that information. I further certify I am the property owner, or a duly authorized representative,and may sign this permit application on behalf of the owner(s) of said property, and I have read and understand all ofthose conditions. I understand that failure2.I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane CountyDepartment of Planning & Development to determine compliance with the countys zoning ordinances. This consent isvalid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate ofcompliance or until earlier revoked in writing by the owner of the property.A location survey, by a licensed surveyor, is required if your construction PRINT: Owner/Agent DATE:You will need to hire a surveyor to prepare a location survey to verify the construction location.The survey shall be done at the time when foundations or basement walls are completed.A location survey shall be submitted to the zoning office before continuing work on the project.Note: A location survey may add significant cost to your project. Please contact a Wisconsin Licensed Land Surveyor. you may need this if . . . 1234567890123456789012345678901212345678901234567890123456789012123456789011 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11 2345678901234567890123456789012123456789012345678901234567890121234567890 11
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3 are within 10 feet of any required setb
are within 10 feet of any required setback.See application for explanation.Building Plans – Floor plans drawn to scale showing all rooms and overall layout.Elevations – A front elevation is required to show the height of the structure as seen from thepropertyroad frontage.Required permits/information from other agenciesDriveway permit from State, County or TownTown roads – contact Town Clerk.County Highway – contact Greg Petersen, (608) 266-9081.State and Federal Highways – contact Scot Hinkle, scot.hinkle@dot.wi.gov , (608)5334.Sanitary permit from Environmental Health (608) 242-6515.New homes sites or any building with plumbingAdditions involving bedrooms or major renovations.Erosion Control permit from Land Conservation (608) 224-3730.Construction within 1000 feet of lake or 300 feet of stream.Construction of a driveway more than 125 feet long.Construction involving steep slopes �(12%) or more than 4000 square feet.Fee - $50.00 base fee and $0. per square foot including porches, decks and all basement areas forresidential projects; $20 base fee and $2.00 per $1000.00 of overall cost for commercial/industrialprojects. Additional fees may apply.Additional information may be required. Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be submit location survey if required.SECOND INSPECTION - When the building is substantially completed call 266-4266.A Certificate of Compliance willzoning ordinance requirements are met. QUESTIONS? Please call our office at (608) 266-4266 or contact us by email at Zoning@ with any questions. !! ZONING PERMIT APPLICATIONwww.countyofdane.com PRPRPRPROPEROPEROPEROPERTY OTY OTY OTY OTIONTIONTIONTIONPRPRPRPROPEROPEROPEROPERTY/LTY/LTY/LTY/LOCAOCAOCAOCA.co.co.co.co.dane.dane.dane.dane.wi.us/).wi.us/).wi.us/).wi.us/) OWNER ADDRESS (Number, Street, City, State, Zip) HOME PHONEPARENTPARCEL WWWWeeeeb-Ab-Ab-Ab-App #pp #pp #pp # AAAATIONTIONTIONTION AGENT ADDRESS(City, State, Zip)E-MAIL ADDRESSE-MAIL ADDRESS CONTRACONTRACONTRACONTRACTCTCTCTTIONTIONTIONTIONCONTRACTOR NAMECONTRACTOR ADDRESS(City, State, Zip)E-MAIL ADDRESS PARCEL NUMBER:CURRENT ZONING: ACREAGE: SECTION:________ ¼:________ ¼:________ TOWNSHIP: LOTSUBDIVISIONBLOCK/LOT PRPRPRPRTIONTIONTIONTION This project is a new building or structure.This project is an addition/alteration to an existing building or structure. SANITARY SERVICE: PERMIT NUMBER: HEIGHT IN FEET:NUMBER OF STORIES: (Not including basement)AREA TO NEAREST SQUARE FOOT:(Outside dimensions including unfinished area, attached garages and above grade decks or porches) Zoning Status; CUP;Variance (#___________)frontage drawn to scale.Driveway permits(state, county, town)Sanitary permits BASEMENT:TOTAL SQUARE FOOTAGE: ESTIMATED CONSTRUCTION COST: "" 1.The property is within 300 feet of a stream or 1000 feet from a pond or lake?...........2.Is there a wetland or floodplain on or near the property?3.Have you talked with the township about your project and are they in agreement?....4.Has there been a zoning permit issued for this property in the past 5 years?.............5.Is this project associated with a rezone/CUP/variance (petition/appeal #_________)6.Is a location survey required? (see reverse)..............................................................7.Is this to correct a violation?.......................................................................................YesYesYesYesYesYesCUSTOMER TO PROVIDE APPLICATION MUST BE SIGNED () Wetland/Floodplain/Shoreland (attachment)STAFF REVIEW 0.0 Dane County Zoning Permit A Zoning Permit is required prior to obtaining a Town Building Permit. Permits from other regulatory agencies such as Dane County Land Highway Department, and/or State Department of Transportation may be needed prior to a Zoning Permit being issued . Zoning permits new construction, any size structure that is placed upon a permanent A permit would also be required if you are changing the use of any existing building on the property. A permit may be obtained by either coming into our office directly or by mailing in all appropriate information and fees to Dane County Planning and Development, Zoning Division, City County Building, Rm 116, 210 Martin Luther King, Jr., Blvd., Madison, WI 53703-3342. If all required information is available, permits are REQUIRED ITEMS To Obtain a Zoning Permit: caled drawing showing thelines. Thelocationered Land
4 Sursigned and dated by either thewithinS
Sursigned and dated by either thewithinState, CouChristine Walker, (608)Health (608) 242itionsromLand Conservation (608) 224-3730.Construction of athan 4000 Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be FIRST INSPECTION- When the foundation or baseme submit location survey if required.NSPECTION - When the building is substantially completed call 266-4266.A Certificate of Compliance willzoning ordinance requirements are met. or contact us by email at any questions. A Zoning Permit is required prior to obtaining a Town Building Permit. Permits from other regulatory agencies such as Dane County Land hway DepartmenDepartment of Transpotation may be needed prior to a Zoning Permit beingZoning permits are required fo new construction, any size structure that is placed upon a dation, buildings that are eater than square feet with out a foundatio an mor alterations existing structures. A permit would a be required if you are changing the use of any permit may be obtained by eitherming into our officedirectly or by mailing in all appropriateormation ning and DevelopmenBuilding, RmMartin Luther King, Jr., Blvd., Madison, WIinformation is available, permits argenerally issued that same day. REQUIRED ITEMS To Obtain a Zoning Permit: caled drawing showing thelines. Thelocationered Land Sursigned and dated by either thewithinState, CouChristine Walker, (608)Health (608) 242AdditionsromLand Conservation (608) 224-3730.Construction of athan 4000 Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be FIRST INSPECTION- When the foundation or baseme submit location survey if required.SECOND INSPECTION - When the building is substantially completed call 266-4266.A Certificate of Compliance willzoning ordinance requirements are met. or contact us by email at any questions. A Zoning Permit is required rior to obtaining a Town Buildinmit. Permits from other regulatory e Coutment, and/or State new building over 120 square feet, any modifications or alterations Martin Luther King, Jr., Blvd., Madison, WI REQUIRED ITEMS To Obtain a Zoning Permit: caled drawing showing thelines. Thelocationered Land SurwithinState, CouChristine Walker, (608)Health (608) 242-6AdditionsromLand Conservation (608) 224-3730.Construction of athan 4000 Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be FIRST INSPECTION- When the foundation or baseme submit location survey if required.SECOND INSPECTION - W substantially completed call 266-4266.A Certificate of Compliance willzoning ordinance requirements are met. or contact us by email at any questions. oning Permit is required prior to obtaining a Town BuildingPermit. Permits from other regulatory e County Land Highway Department, and/or State new building over 120 square feet, any modifications or alterations coming into our officedirectly or by mailing in all appropriateand fees to Dane County Planning and Developmeninformation is available, permits are REQUIRED ITEMS To Obtain a Zoning Permit: $50.00 base fee and $0.residential projects; $20 base fee and $2.00 per Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be FIRST INSPECTION- When the foundation or baseme submit location survey if required.SECOND INSPECTION - When the building isA Certificate of Compliance willzoning ordinance requirements are met. or contact us by email at any questions. A Zoning Permit prior to obtaining a Town BuildingPermit. Permits from other regulatory agencies such as e County Land Highway Department, and/or State new building over 120 square feet, any modifications or alterations coming into our officedirectly or by mailing in all appropriateand fees to Dane County Planning and DevelopmenMartin Luther King, Jr., Blvd., Madison, WIinformation is available, permits are REQUIRED ITEMS To Obtain a Zoning Permit: $50.00 base fee and $0.residential projects; $2 Environmentally sensitive areas (wetlands-floodplain-shoreland).Legal parcel status (determination of status may be FIRST INSPECTION- When the foundation or baseme submit location survey if required.SECOND INSPECTION - When the building is substantially completed call 266-4266.A Certificate of Compliance willzoning ordinance requirements are met. or contact us by email at any question