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r u <br /> ZONNG PERIAT APPUC1411ON vHnnnicaouri yofdane.corn SUPPLEMENT to Web App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Bill & Jean Eberle <br /> ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 1251 Kerry Drive, Sun Prairie, WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 608-332-8964 weberle(c�amfam.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten Marten Building & Design ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> P.O. Box 64 P.O. Box 64 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Sun Prairie, WI 53590 Sun Prairie, WI 53590 <br /> PHONE PHONE ❑Site Plan approval from <br /> 608-212-6934 608-212-6934 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randyamartenbuilding.com randyAmartenbuilding.com ❑ 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 /> ❑PARCEL 091130113100 ,758 frontage drawn to scale. <br /> NUMBER fa-1---/4- ' <br /> TOWNSHIP: SECTION: <br /> Bristol 19 14: NE 1/41/4: NW CI Driveway permits <br /> ADDRESS: (state,county,town) <br /> 0'9 09 ,R -3b EhJ CAR. <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 11 Grandview Park (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family New Contruction ❑ Zoning District <br /> ZThis project is a new building or structure. ❑ Permitted Use? <br /> ['This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER OEPTIC 13-2014-00010 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 24.5' 1 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ <br /> ErosionControl permit <br /> 2000 3255 4, TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 5255 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -i ♦ -► and available options. <br /> (Please round to nearest dollar) 339,526.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes [ lo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes OW ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? JYes ow <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/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) [ Yes fNo ['Don't know <br /> 7. Is this to correct a violation? Elves Ilo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) ■ ■ -► <br />