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_.. .., .. --/ ( , i-te <br /> SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> David & Wendy lanne ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 3038 Bunker,Sun Prairie WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 DAVE(ANNE<iannedave @yahoo.com> ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders,Inc. ❑Site Plan' clu ' g location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/se i <br /> 102 N Holiday Drive 102 N Holiday Drive <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Waunakee WI 53597 Waunakee WI 53597 <br /> PHONE PHONE ❑Site Plan -•pr■ 1•"om <br /> (608) 849-6770 (608) 849-6770 applicabl.J'• i•. <br /> E-MAI L ADDRESS E-MAIL ADDRESS <br /> jeanette.acker @tds.net jeanette.acker @tds.net ❑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 /> n PARCEL 0911-303-0524-0 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: ^ SECTION: <br /> 1IOndsOr■ If0 It t \ 30 '/4: ne 1/41/4: sw ❑D ' e rmlt5 <br /> ADDRESS: y �� G (s un ,town) <br /> Vq..7 �I��✓V/' t' c� 4)1N . ❑Sani . • • <br /> CSM: LOT SUBDIVISION BLOCK/LOT � <br /> 64 Bristol Gardens (public, 1 I e) <br /> PROPOSED PROJECT INFORMATION ' : '.-'`' Lid =, <br /> PROJECT DESCRIPTION: x '" 'qx <br /> New home construction L s4°, . , <br /> This project is a new building or structure. <br /> a . 9 -i-' <br /> ❑This project is an addition/alteration to an existing building or structure. s � °., <br /> SANITARY SERVICE: PERMIT NUMB gt:(� !, t j1 f t n t x ' <br /> EWER [EPTIC 1111 v I « yu, <br /> HEIGHT IN FEET: / i NUMBER OF STORIES: (Not induding basement) <br /> ,/c 1.0 , 4 _ � i <br /> AREA TO EAREST SQUARE FOOT: <br /> (Outside dimensions including unfinis area,attached garages and above grade decks or porches) ..' ,r ,pe— tw <br /> BASEMFyT� �� 1ST FLOOR: .` <br /> '!��._JJ// j TOTAL SQUARE FOOTAGE: + t; -4 ,• • , <br /> �'" ��mg/access) <br /> 2ND FLOOR: 3RD FLOOR: S co I <br /> /F✓-------���°R . Xr,., . . eye <br /> ESTIMATED CONSTRUCTION COST: an cl• - _•t'• , <br /> (Please round to nearest dollar) -♦ ♦ ♦ ♦ ♦ ♦ $ iiG f C e �/ <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 No ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes alo <br /> 5. Is this project associated with a rezone/CUP/vari a(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see rev ❑Yes ❑No 51Don't know <br /> 7. Is this to correct a violation? Elves ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> 545-112 O (Continue on Back) -+ -+ <br />