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ZONING PERMIT APPLICATION www.countyofdane.com I <br /> I 1 <br /> PROPERTY OWNER INFORMATION ''' ` '" `'' . -... 2;`: <br /> CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Premier Builders, Inc. E Zoning Status UP, <br /> OWNER ADDRESS (Number,Street.City.State.Zip) Deed s ction; CSM <br /> 102 N Holiday Drive,Waunakee WI 53597 Variance(# ) <br /> HOME PHONE CELL PHONE EMAIL ADDRESS <br /> (608)849-6770 jeanette.acker @tds.net C Site Plan dray o scale <br /> AGENT INFORMATION CONTRACTOR=INFORMATION, fF.,f :`3,1';':'$,:,. and includ dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders, Inc. I 1 Site P -II ,t ;rlr..iin() loCC.tio <br /> AGENT ADDRESS CONTRACTOR ADDRESS ofv.,eilt i;lic <br /> 102 N Holiday Drive 102 N Holiday Drive <br /> (City.ty State,Zip) (Cty State,Zip) [^ SCt V s <br /> Waunakee WI 53597 Waunakee WI 53597 <br /> PHONE •PHONE — 0 Site PI wv I from <br /> (608) 849-6770 (608) 849-6770 appli b .wn hip. <br /> E-MAIL ADDRESS EMAIL ADDRESS <br /> jeanette.acker @tds.net jeanette.acker @tds.net C Floor plan scale <br /> PROPERTY/LOCATION INFORMATION (httiisl/aocossdans co.dane.Wi tis/) Elevat o of property <br /> PARENT PARCEL NUMBER' CURRENT ZONING ACREAGE' <br /> Ig PARCEL 0708-193-2034-4 NUMBER frontag drawn to scale. <br /> TOWNSHIP: SECTION <br /> Middleton 19 1/: nw '/.t'/,: sw __ I Driver:, ; a r�Q,- <br /> -- --- "_._ _ ._ ._._............_._--.—..-- (s t E t e ,o U y t C 1 <br /> ADDRESS 3853 Pheasant Point Ct — <br /> Sanitary permits <br /> CSM. LOT SUBDIVISION _ — BLO DOLOT <br /> Pheasant Point (public, •, -,tea) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New home construction ❑ Zoning r[ ti iict <br /> 51This project is a new building or structure. 0 Permitt cV? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER U Rural Address ore rThEW'ER EPTIC ‘(7_, 1,�Z-.1 XISting) <br /> HEIGHT IN FEE 1 NUMBER OF STORIES: (Not in:loom s n,-nt)• 1.0 J W011,t,d� I� "I <br /> AREA TO NEAREST SQUARE FOOT ShGf_I2�I ' V '' lr I: }� <br /> (Outside dimensions ncluding unfinished area, attached garages and above grade decks or porches) <br /> Li Erosion Vilperi it <br /> BASEMENT. t TfLOOR: <br /> TOTAL SQUARE FOOTAGE: ,l, (slope'/. •. nce, <br /> �C� .__._. 1 filling/.ccess) <br /> 2ND FLOOR: 3R LOOR: <br /> � / '\"' . ❑ Re 'e ..00. or Survey <br /> ESTIMATED CONSTRUCTION COST: <br /> "• "r "� (� and . ,:I' • ions. <br /> (Please round to nearest dollar) "r O <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? nYes I✓ No 'Don't kno.v <br /> 2. Is there a wetland or floodplain on or near the property? 7Yt:s N,/hIc !_]OCn" -:on,, <br /> 3. Have you talked with the township about your project and are they in agreement? [/ "n.: []N!c <br /> 4. Has there been a zoning permit issued for this property in the past 5 yea's? 'Yes [-ZING <br /> 5. Is this project associated with a rezone/CUP/variance (petition/appeal # ) (le ve blank if non-) <br /> 6. Is a location survey required? (see reverse) Yes <br /> 7. Is this to correct a violation? Yes nNo <br /> APPLICATION MUST BE SIGNED <br /> �� ‘4105) (Continue on Back) —, —► -+545- <br />