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• <br /> • SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> r <br /> PROPERTY OWNER INFORMATION C STOMER TO PROVIDE <br /> OWNER NAME <br /> Dan & Katie Selz oning Status;CUP; <br /> OWNER ADDRESS ((Number,Street,City,State,Zip) ` , (Dee Restriction; CSM <br /> -1 a tD 04,1;,,„y. S ' . S Jw,, rnu_�--L,�, A - Variance(# ) <br /> HOME`ONE CELL PHONE E-MAIL ADDRESS 5.3 D <br /> r : — ^ (e 4 t Sile Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dan Waldner Waldner Construction Inc 61S e Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS well/septic <br /> P O Box 1103 P O Box 1103 <br /> (City,State,Zip) (City,State,Zip) Setbacks / <br /> Sun Prairie Wi 53590 Sun Prairie W 53590 <br /> PHONE PHONE ❑Si Plan proval from <br /> (608) 235-4371 (608) 235-4371 fi plica/b a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> danieljwaldner @yahoo.com danieljwaldner @yahoo.com loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRE ONING: ACREAGE: Elevation of property <br /> ❑NUMBER 0910-293-6353-0 N 0.41 frontage drawn to scale. <br /> TOWNSHIP: SECT( ' R - , ❑�rIVeW permits <br /> Town Of Windsor �� /a: W �a14: _ stiv county,town) <br /> ADDRESS�?'?. �_ � ..� <br /> q3 3 b ��2 y C Sa I ary permits <br /> CSM: LOT 33 SUBDIVISION BLOCK/LOT <br /> Prairie Creek (p blic,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: A r <br /> New Home Construction W / ,e k.ci_ 01 C R oning District <br /> . 0 This project is a new building or structure. • P rmitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 1 Address <br /> EWER SEPTIC (ne /existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 20.0 1.0 tla oodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shore (attach nt) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1 ST FLOOR: ❑ ErosionC• •1 permit <br /> 1,840.0 2,898.0 + TOTAL SQUARE FOOTAGE: j 'slopes, •'- ••nce, <br /> 2ND FLOOR: 3RD FLOOR: iling/ • . ) <br /> 0.0 0.0 4,738.0 <br /> eview Location Surve fe <br /> .____.. <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ - ♦ - $ 230,000.00 <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 'lo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑Yes Elo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ZNo <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 1=11No ['Don't know <br /> 7. Is this to correct a violation? ❑Yes Jo <br /> J APPLICATION MUST BE SIGNED <br /> / } (Continue on Back) <br /> sas-viz(4/08) v <br />