HomeMy WebLinkAbout2005-2564Grant County Zoning
Terry Loeffelholz
111 S Jefferson St. Lancaster, WI 53813
(608) 723-2848
2005 APPLICATION FOR ZONING PERMIT #
2564
DATE ISSUED: ,S_ 13-0 ,- DATE EXPIRES: s 3 00
TO THE GRANT COUNTY ZONING ADMINISTRATOR: The undersigned hereby makes application for a
Grant County Zoning Permit for work described n to be doneand located hinrein. The aacordanceWith thbrequ'srements of the Chant County
is respoOsible for all
wark/impro�+aments {described in this application) } and Zoning Ordinance and all other applicable township and county te rant ordinances
CountZoning Ordinance. State of Wisconsin.
Failuure to comply with these requirements is a violation
. Tms ZONING pERMFT IS GOOD FOR I YEAR. ermit needs to be issued from the Grant
NEW HOMES: Before the Zoning Permit can be issued a Sanitation-p
County Sanitation offim
Owner
Mailer Address �i ►t ���.
538 18 Phone number: (WO
dimension of structure or work to be d= (Provide sketch on back of this form).
WORK TO BE DONE: describe
e
— I q.0 s o —� -0, 000
NUMBER OF BEDROOMS: 3
NAME OF BUILDER:
NUMBER OF STORIES: I
- sQUARE FT:. / L1
FEE SCHEDULE is based upon the value of the proposed construction/ixnprovement to the property with a
MININ UM -of $25.00 or $1.00 per $1,000.00 over $25,000.00 of value..
VALUE OF WORX/IMPROVEMENT:
FEE ENCLOSED:$o
,, n.*P. 5-13 -oS
OFFICE USE ONLY
Township: Zoning District:
Legal: S4,) 7r oZ� Tax .parcel- #
Sub Division.;
Road:
Minimum Setback Requirements: Side Yard Ft. Rear Yard
Front Yard � . I=t. Center of StreetlRoad
t.
Date vaid: cS / s� o J'
Terry L oefPelholz:L"W_
-F
S
a
PARCELSKETCH
Please provide location of work being done, location and distances from septic tank, drain
field, well, property line and roads for the following improvements:
• Structurelimprovement being applied for In this application
• Existing structures (label) on your property
other structures (label) within 1000 feet of your property.
Name of road coming off of for new strictures,
Rear Lot Line
1,' ont Lot Line
Name of Road/Street; 5 `% ; ne Lar%4e-
Township & location of work being done.�Y r Son �o W na 1� i
Tax Parcel number (if known):
Do you currently own this property? Yes ❑No
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