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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Ws-App# <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> ADAM WAYMAN <br /> OWNER ADDRESS (Number,Street,City,State,Zip) _ --- ---i. ii Zoning Status:CUP: 4, — i <br /> 600 CAMP STREET BARABOO,WI 53913 deed Restriction; CSt.1 <br /> HOME PHONE CELL PHONE --,-- �,--...__... ____ ; Variance(! <br /> E-MAIL E•MAILADDRESS <br /> (608)356-2332 <br /> g Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR=INFORMATION`' and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> DAN BEAL CRAFTSMAN CONSTRUCTION E4 ' -._,._', luding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS ■ 0 well/sep i <br /> 600 CAMP STREET 600 CAMP STREET �7� ,l <br /> (city,State,Zip) (City,State,Zip) ��— 1�l Setbacks 3�1-54 _CO <br /> BARABOO,WI,53913 BARABOO,WI 53913 7"— <br /> PHONE PHONE Igi,3ite Plan approval from �, ' <br /> E-MAIL ADDRESS (608) 356-2332 (608) 356-2332 applicable township. <br /> EMAIL ADDRESS <br /> jeremy@craftsmanbuilding.com Jeremy @craftsmanbuilding.com j door plans to scale X., r <br /> PROPERTY/LOCATION INFORMATION-,1hftpei/O P I <br /> PARENT PARCEL NUMBER: CURREN ZONIN : ACREAGE- iovallor,Of propetty i <br /> PARCEL <br /> D NUMBER 012/0911-303-2332-0 0.76 t 7g ; frontage drawn to� a,:. <br /> TOWNSHIP: -.._._..__SEC1 ION <br /> BRISTOL 30 I/: NW <br /> /a�/: SNN 1 riveway perm' <br /> ______ ___.. (state,county <br /> )ADDRES 0 <br /> FRAN DRIVE, BRISTOL, WI 53590 c <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary tS <br /> 62 BRISTOL GARDENS public, l..4 <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PR JEC r.;„ ON: <br /> W C 0 k 0 r', ac 4 et r i/ 4 4 '(D `4 Zoning District <br /> Q This project - a ne 'wilding or structure. 1'4 Permitted Use? SF 4 <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> t/!�. <br /> dt0it3/ V SANITARY SVICE: EPTIC 13,201,400,406 ing) <br /> HEIGHT IN FEET. NUMBER OF STORIES: (Not including basement) <br /> 2 .0 2.0 etland/Floodpiain/ A_ <br /> AREA TO NEAREST SQUARE FOOT: _._.4 Shoreland (attachment) / <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> � <br /> MI ErosionControl r <br /> BASEMENT: /� 1ST FLOOR: permit <br /> 1,800.0 3,420,0 4 TOTAL SQUARE FOOTAGE: ,,, (slopes,disturbance, A J� _ 11 <br /> 2ND FLOOR: 3RD FLOOR ) <br /> 1,450.0 6,670.0 <br /> i4 Review Location Surve <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) -+ -+ -► .- -. $ 550 000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes HNu, 11C,en'I k r: .: <br /> 2. Is there a wetland or floodplain on or near the properly? f lYes EN() Don'1 k is <br /> 3. Have you talked with the township about your project and are they in agreement'? [lYes V No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Eyes 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) Efres 12 No f Don't know <br /> 7. Is this to correct a violation? Des is No <br /> APPLICATION MUST BE SIGNED <br /> 545412(4/08) (Continue on Back) -► -► --i• <br />