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v <br /> ZONING �,cA11ON OO_ __l_�_ awn SUPPLEMENT to Web App # <br /> PROPERTY OWNER INFORMATION l/�� <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Blake & Geri Hart <br /> g__,-- / <br /> OWNER ADDRESS (Number,Street,City,State,Zip) �ZOning Status;CUP; <br /> W4737 Super Dr., Campbellsport, WI 53010 speed Restriction;CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> 920-539-7195 harts4(a7att.net 'Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten Marten Building & Design <br /> AGENT ADDRESS Site Plan including location <br /> CONTRACTOR ADDRESS of well/septic <br /> P.O. Box 64 P.O. Box 64 1//`)/�5/ <br /> (City,State,Zip) -� <br /> Sun Prairie, WI 53590 (City,State,Zip) ►./ Setbacks <br /> Sun Prairie, WI 53590 ro <br /> PHONE PHONE ,'Site Plan approval from <br /> 608-212-6934 608-212-6934 applicable township. /4- <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randy(c�martenbuildinq.com randy a martenbuildinq.com 124Floor plans to scale r <br /> Xf El PARCEL <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: levatlorl of property <br /> NUMBER I 091119470762 R1 2.260 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Bristol 1A: %1A: Driveway pe <br /> ADDRESS: //��""��"(state,cou ty own) <br /> 2916 Pebble Valley Court, Sun Prairie, WI 53590 <br /> X -... <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary ,-- <br /> 6 Pebble Valley (publir,private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: STAFF REVD <br /> Single Family New Contruction /6 Zoning District ({ <br /> This project is a new building or structure. 4❑ <br /> 6iie'^-4., <br /> This project is an addition/alteration to an existing building or structure. l�Permitted Use? <br /> SANITARY SERVICE: QiP� <br /> PERMIT NUMBER: - - _ - <br /> VIEWER 7EPTIC 13-2015-00206 ,_'`'xisting) - <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement)23.5' 1 loodplai "'�_r X <br /> /� <br /> AREA TO NEAREST SQUARE FOOT: S el id (attachment) 417 <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ArEiosi �`ontrol perm�` e <br /> it <br /> BASEMENT: 2340 1ST FLOOR: r1 O <br /> 3836 4 TOTAL SQUARE FOOTAGE: 4 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) a ♦'r''r M <br /> 6176 <br /> ESTIMATED CONSTRUCTION COST: Review Location Survey <br /> (Please round to nearest dollar) '• '* '► ♦ 558 806.56 and available options. / <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ZiNo QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes alo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? Wfres alo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes OW <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# <br /> (leave blank if none) <br /> 6. Is a location survey required? (see reverse) QYes lNo QDon't know <br /> 7. Is this to correct a violation? QYes WiNo <br /> , <br /> //n / //2 !� APPLICATION MUST BE SIGNED <br /> 545-112(4/08) /// , / (2-a J— //L (Contitinue on Back) —0 <br /> /� 6 /D , )(L 2/10- - 73; v <br />