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q-4) .3_3 SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Daniel & Kayla Thompson <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Q Zoning to s;CUP; <br /> Deed R riction;CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (612)240-7765 DanbThompson @edinarealty.com '4 Site Plac dydwn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and incl es dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Ambiance Homes Inc Ambiance Homes Inc D Site I including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of w sep ' <br /> 5838 Grassland Terrace 5838 Grassland Terrace <br /> (City,State,Zip) (City,State,Zip) Q Set S <br /> Marshall,WI 53559 Marshall,WI 53559 <br /> PHONE PHONE 0 Site P .n .r: al from <br /> (608) 225-4594 (608) 225-4594 appli•{'• - !wn ip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ambiancehomesinc @charter.net ambiancehomesinc @charter.net fil Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevat n property <br /> DPARCEL 012/0911-193-0089-0 A-1 1.19 frontage rawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Bristol 19 '/4: NE 1/41/: SW 0 Drivew <br /> ADDRESS: (state, y,t n) <br /> Parker Pass <br /> 0 Sanitqry pymits <br /> CSM: LOT 9 SUBDIVISION BLOCK/LOT (publi vate) <br /> 7 Parker's Place <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family Residential LI Zoning DW trict <br /> IN This project is a new building or structure. ❑ Permit Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural-Address <br /> EWER PEPTIC 13,201,500,196 '!J xisting) <br /> HEIGHT�J FEET: 1 b NUMBER OF STORIES: (Not including basement) <br /> 7�\ U1sn 22.5 ;y• .in/ <br /> AREA TO NEAREST SQUARE FOOT: 1.0 ❑ Wetlan• FI <br /> Shorel- • a- .chment) <br /> (Outside dimensions including unfinished area,attached garages a bove grade decks or porches) <br /> BASEMENT: 1 ,961 .0 1ST FLOOR: 4 �3 TOTAL SQUARE FOOTAGE: ❑ (slopeS Sn nCe,lt 4, <br /> 2ND FLOOR: 3RD FLOG <br /> �7 4, filling/access) <br /> 0.0 .6709670 5-11 <br /> ❑ Revie ►r-'i: survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ and av • • - o• ions. <br /> (Please round to nearest dollar) $ 240,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ✓7 o QDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Dyes go DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? Dyes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? DYes ✓ao <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) J: Yes QNo DDon't know <br /> 7. Is this to correct a violation? Elves ✓Dnlo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) -, ♦ -. <br />