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ZONING PERMIT APPLICATION www.countyordane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> State At Main Development / <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Q Zoning Status;CUP; <br /> 200 N MAIN ST OREGON WI 53575 Deed Restriction; CSM <br /> HOME PHONE CELL PHONE Variance(# ) <br /> E-MAIL ADDRESS <br /> ite Plan drawn to scale <br /> AGENT INFORMATION <br /> CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Daniel J Waldner Waldner Const Inc Site Plan including location <br /> AGENT ADDRESS g <br /> CONTRACTOR ADDRESS of well/septic <br /> PO BOX 1103 PO Box 1103 <br /> (City,State,Zip) (City,State,Zip) L!d Jetbacks <br /> Sun Prairie Wi 53590 Sun Prairie Wi 53590 <br /> PHONE PHONE ite Plan approval from <br /> (608) 235-4371 (608) 235-4371 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> danieljwaldner @yahoo.com danieljwaldner @yahoo.com Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi-us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: levation of property <br /> 0 PARCEL 0910-293-6678-0 fronta <br /> NUMBER R-4 0.22 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Windsor 1/4: ,/4,/: \ Driveway permits <br /> ADDRESS (state,county,town) <br /> L..1-;s3 Scenic View Road <br /> CSM: LOT SUBDIVISION BLOCK/LOT a 'r i;-ry permits <br /> 98 Prairie Creek public,private) <br /> PROPOSED PROJECT INFORMATION AF <br /> PROJECT DESCRIPTION: �, <br /> New Construction Home L7"Zoning District <br /> 0 This project is a new building or structure. <br /> La/Permitted Use? <br /> DThis project is an addition/alteration to an existing building or structure. <br /> SANITARY S RVIC : PERMIT NUMBER: ❑ t110 AO ress <br /> PEPTIC (\ -Xisting) <br /> HEIGHT IN FE NEWER <br /> NUMBER OF STORIES: (Not including basement <br /> 24.0 2.0 9 ) ❑ vetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: oreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ErosionControl permit <br /> 1,184.0 2,074,0 j, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 1,181-0 3RD FLOOR:0.0 fllling/access) <br /> 4,439.0 <br /> ESTIMATED CONSTRUCTION COST: Review Location.Survey <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ —► $ 260,000.00 nd availe . <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes Olo DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Dyes to ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? JYes EINo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dyes Jlo <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) Q✓Yes :IVO DDon't know <br /> 7. Is this to correct a violation? Dies ✓iNo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) <br />