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N. <br /> ZONINZ�OryN��IN�rG SUPPLEMENT to <br /> G 1 � � � ' Web App # <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> Marten Building & Design <br /> OWNER ADDRESS (Number,Street,City,State,Zip) ❑Zoning Status;C <br /> P.O. Box 64, Sun Prairie, WI 53590 Deed Restri I CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> 608-212-6934 randy(a�martenbuilding.com 0 Site Plan drawn t Cale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION <br /> AGENT NAME and includes i nsions <br /> CONTRACTOR NAME <br /> Randy Marten Marten Building & Design <br /> AGENT ADDRESS ❑Site Plan inclt{di location <br /> P.O. Box 64 CONTRACTOR ADDRESS of well/septic <br /> P.O. Box 64 <br /> (City,State,Zip) (City,State,Zip) ❑Setbakfcs <br /> Sun Prairie, WI 53590 Sun Prairie, WI 53590 <br /> PHONE PHONE <br /> 608-212-6934 608-212-6934 Site Pla .•. . al from <br /> applicaf le ,,w .hip. <br /> E-MAIL ADDRESS <br /> E-MAIL ADDRESS <br /> randyamartenbuilding.corn randyamartenbuildinq.com ❑Floor plans N ale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> ElPARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 0 Elevation of operty <br /> NUMBER 091119300010 Al 884 frontage dr n to scale. <br /> TOWNSHIP: SECTION: <br /> Bristol 19 14: %IA: ❑Drive ty� Its <br /> ADDRESS: r <br /> (state <br /> i( C, �w� ty,town) <br /> CSM: LOT 1 SUBDIVISION BLOCK/LOT ❑Sanitary p mit <br /> Parker Pass (public,privl <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: STAFF REVIEW <br /> Single Family New Contruction ❑ Zoning Di <br /> • ZThis project is a new building or structure. ���/ <br /> lj <br /> ['This project is an addition/alteration to an existing building or structure. Perrrnttede? <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Address <br /> 17EwER 0EPTIC 13-2015-00259 (ne /existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 22'-0" 1 ❑ WBtla ./ • ,: ,'s_ <br /> AREA TO NEAREST SQUARE FOOT: Shorel. : ment) <br /> (Outside dimension cluding unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ Erosio r,j�y• •_rmit <br /> 2070 3412 4 TOTAL SQUARE FOOTAGE: 4 (- ••:,r s•�','f : •.:, <br /> 2ND FLOOR: 3RD FLOOR: fifll • c•r <br /> 5482 <br /> ESTIMATED CONSTRUCTION COST: ❑ Re ' •s" aZ j(y t� <br /> (Please round to nearest dollar) ♦ —� —► -♦ —► ♦ 305 022.00 and � '' ••t �s. <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? []Yes WiVo DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes ao ['Don't know ' <br /> 3. Have you talked with the township about your project and are they in agreement? JYes ao <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Elves 7 io <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) Elves o ['Don't know <br /> 7. Is this to correct a violation? QYes JVo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) -► -► <br />