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itorc find r p e',vt A/t t 1,\,- 3, ,i-v Daz 1 <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> NATURE VALLEY CONSERVANCY NEIGHBORHOOD LLC <br /> ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City.State,Zip) Deed Restric{i ; CSM <br /> 102 N Holiday Drive Waunakee WI 53597 Variance(# <br /> HOME PHONE 'CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 jeanette.acker @tds.net ❑Site Plan drawn to scale <br /> AGENT INFORMATION 1 CONTRACTOR INFORMATION and includes irons <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders,Inc. El Site PI I ng location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well 'tip <br /> 102 N Holiday Drive 102 N Holiday Drive <br /> (City.State,Zip) (City,State,Zip) ❑Sett1vat s <br /> Waunakee WI Waunakee WI 53597 v/ <br /> PHONE PHONE ❑Site Pla I from <br /> (608) 849-6770 (608) 849-6770 applic W ship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Jeanette.acker @tds.net JEANETTE.ACKER @TOS.NET ❑Floor pl scale <br /> PROPERTY/LOCATION INFORMATION (httpa/accessdane.co.t*ane.wi.usf) Elevati n of operty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 0 PARCEL 0909-363-6582-0 frontag wn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> VIENNA 36 +A. SE x/%: sw ❑DrivewAygerd <br /> ADDR£S (state c n ,t•wn) <br /> oaf a Alcd-lo e live- � <br /> ❑S S. .: permits <br /> CSM LOT SUBDIVISION BLOCK/LOT <br /> 82 NATURE Valley •Uhf•,private) <br /> PROPOSED PROJECT INFORMATION STAFF' VIEW <br /> PROJECT DESCRIPTION: <br /> new single family home rc<6(4e . 0 (o ❑ Zonin D riot <br /> . 151This project is a new building or structure. ❑ Permitt,Verse? <br /> This project is an addition/alteration to an existing building or structure. r-t " <br /> SANITARY SERVICE: Alin PERMIT NUMBER: 0 R •=I Address <br /> 131.4.EWER _ �EPTIC existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 23.0Jr� 1 I 1.0 0 Wetland/ to in/ <br /> AREA TO NEAREST SQUARE FOOT. ShOrel- ent)' <br /> (Outside dimensions including unfinished area attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> ❑Erosion i ntrpl permit <br /> 1,870.0 3,306.0 l TOTAL SQUARE FOOTAGE: j, (sib! ' is, .ante, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filli al- ess) <br /> 5,176.0 r <br /> ESTIMATED CONSTRUCTION COST: ♦ -r ♦ -► ..,•, ,I<■, e ,•bolt$. <br /> (Please round to nearest dollar) $ 400,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? l'es UNo ]Don't know <br /> 2. Is there a wetland or floodplain on or near the property? JYes igNo 0Don't know <br /> 3. Have you talked with the township about your project and are they in agreement?.... 4.2- es Jlo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes Elo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (lea ye blank if none) <br /> *Ise location survey required? (see reverse) [ 'es. [Ilo ]Don't know' <br /> 7. Is this to correct a violation? [Yes aio <br /> APPLICATION MUST BE SIGNED <br /> 545-112„ 1 (Continue on Back) -.• -o. -•• <br />