Laserfiche WebLink
40(4 1°S <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME ^ <br /> 0 Zoning St tus. UP; 't <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Res • ion;CSM <br /> Premier Builders,Inc. Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 (608)849-6770 jeanette.acker @tds.net El Site Plan raw o scale <br /> AGENT INFORMATION {CONTRACTOR INFORMATION and includ s imensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker PREMIER BUILDERS,INC. [Site Plan jpeluding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of welVelptic <br /> 102 N Holiday Drive 102 N HOLIDAY DRIVE <br /> (City,State,Zip) (City.State.Zip) [Set <br /> Waunakee WI 53597 WAUNAKEE WI 53597 <br /> PHONE PHONE 0 Site I from <br /> (608) 849-6770 (608) 849-6770 appl a o ship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS . <br /> JEANETTE.ACKER @TDS.NET JEANETTE.ACKER @TDS.NET 0 Floor pla //o scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wif.usJ) EleVatiOft�df property <br /> PARENT PARCEL NUMBER: CURRENT NING: ACREAGE: E evage���jjI"pr to scale. <br /> WA PARCEL 0911-192-0557-0 \ <br /> NUMBER <br /> TOWNSHIP: SECTION: , <br /> Bristol 19 1/4: NE WA: NW ❑Drive y //.its <br /> (stat c y,town) <br /> ADDRESS' �,p <br /> -, Pq3 1 '` Dc 'e- ❑SanitanApefrnits <br /> CSM: LOT SUBDIVISION BLOCK/LOT (public,private) <br /> 17 NORWAY ESTATES <br /> PROPOSED PROJECT INFORMATION ''STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> <G ❑�Arlin00t t. <br /> . 4 This project is a new building or structure. ❑Pe se? , <br /> This project is an addition/alteration to an existing building or structure. 0. � <br /> ❑'RUM!Address <br /> SANITARY SERVICE: PERMIT 1U�9¢ER:20 l 5_CO MM ( rJ <br /> EWER / EPTIC iJ� W `-'[ /eXlSting). <br /> HEIGHT IN FEE) NUMBER OF STORIES: (Not including basement) \ <br /> 33.0 2.0 ❑ wetlan ain/ <br /> Shorelln �chment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ EIosi,n r ,' • permit <br /> BASEMENT: 1,175.0 1ST FLOOR: 2,401.0 ,`. TOTAL SQUARE FOOTAGE: 4, (sic)• rbance, <br /> filling/access) <br /> 2ND FLOOR: ��1,145.0 RD FLOOR: 4,721.0 <br /> ,721.O <br /> 4 0 R vi " lion Survey <br /> ESTIMATED CONSTRUCTION COST: options. <br /> (Please round to nearest dollar) —* —4* —► '4' -6* _ $ 300,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes [No [Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes Bo QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes Q✓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) .€5 [Yes [No rdDon't know <br /> 7. Is this to correct a violation? [Yes ✓No <br /> ilo s1/4____ ___ APPLICATION MUST BE SIGNED <br /> (Continue on Back) —.. -4. -4. <br /> 545-112(4108) <br />