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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Randy and Lynn Peters <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 1168 St.Albert the Great Dr,Sun Prairie,WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)669-7808 rlpeters1 @charter.net <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> PO Box 64 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> SunPrairie,Wl 53590 <br /> PHONE PHONE ❑Site Plan approval from <br /> (605) 212-3693 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randy @martenbuilding.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 0 PARCEL 091112101970 A-1 0.97 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Bristol 12 1/4. NE -/41/4: ❑Driveway permits <br /> ADDRESS: / `� (state,county,town) <br /> ;'10 � CS, ix /7 � <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> ST Drumlin Creek (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Construction-Single Family Home ❑ Zoning District <br /> . 0 This project is a new building or structure. ❑ Permitted 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 ' ZQ I two 2.S (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> ❑ Wetland/Floodplain/ <br /> �v +0'Y Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> ❑ ErosionControl permit <br /> —'f- 55b.V ;-0' JZ& 5 , TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 471- filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> S/Y 4& ' ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available O dons. <br /> ♦ <br /> (Please round to nearest dollar) ♦ ♦ -, -► ♦ $ 338,900.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes 'lo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yeslo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ['Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓IJo <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 alo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes al <br /> APPLICATION MUST BE SIGNED <br /> �f 'Z (Continue on Back) <br /> 545-112(4/08) �� �] <br />