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, -' - sT) ii% A 0 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Kyle & Kaleena Stephan <br /> ❑Zonin a s; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed R triction;CSM <br /> 2131 Efffingham Way#109,Sun Prairie,WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (815)990-6806 (815)275-9411 stephankl @gmail.com ❑Site Plan draw scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and inclu Imensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten(Marten Building&Design) ❑Site Pla incl ' g location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/s <br /> P.O.Box 64 <br /> (City,State,Zip) (City,State,Zip) ❑Set kS <br /> Sun Prairie,WI 53590 <br /> PHONE PHONE n Site Pla p from <br /> (608) 212-6934 applicash . <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> randy @martenbuilding.com ❑ Floor plan o scale N5. <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevati f property �` <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 091119205350 1.00 frontag drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town of Bristol 19 1/4; NE 1/41/4. NW ❑Driv f`,u+ s <br /> (Sta� ty, own) <br /> ADDRESS: <br /> Sd a \ (6 f (- .g�e ❑Sanitary rnits <br /> CSM: LOT S BD ISION LOCK/LOT (public,private) <br /> Norway Road Estates <br /> PROPOSED PROJECT INFORMATION STAFF rilEIN <br /> PROJECT DESCRIPTION: <br /> Single Family Home ❑ Zoning i trict <br /> . IN This project is a new building or structure. ❑ Permitt Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER EPTIC 13,201,500,011 existing) <br /> HEIGHT I EET: NUMBER OF STORIES: (Not including basement) <br /> 1.0 ❑ et{an ,N <br /> Sh ( ment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ Eros{o C;,t•• +-rrriit <br /> BASEMENT: 1ST FLOOR: TOTAL SQUARE FOOTAGE: (S{O+ P %nce, <br /> 2,122.0 3,331.0 j <br /> Min( a‘01.,:- ) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 5,453.0 p, <br /> ❑ Revi , "' • Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ — -�► ♦ ♦ ♦ and v ;.r •+tions. <br /> (Please round to nearest dollar) $ 344,561.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes 'lo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes EINo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? res EINo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Elves ✓INo <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 No ❑Don't know <br /> 7. Is this to correct a violation? Dies ✓'lo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ -+ -► <br /> 545-112(4/08) <br />