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ZONING PERMIT APPLICATION ww.countyofdane.com SUPPLEMENT to Web-App # <br /> w <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Johnny & Christy Waldner <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> P 0 Box 1103 Sun Prairie Wi 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)444-7706 ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Daniel Waldner Waldner Construction Inc ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 6692 Covered Bridge Trail 6692 Covered Bridge Trail <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Sun Prairie Wi 53590 Sun Prairie Wi 53590 <br /> PHONE ❑(608) 235-4371 PHONE (608) 235-4371 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> danieljwaldner @hayoo.com danieljwaldner @yahoo.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURREN ZONING: ACREAGE: ❑Elevation of property <br /> PARCEL 0911-194-9581-6 ;"\ — I 1.11 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town Of Bristol 19 /,: %IA: ❑Driveway permits <br /> ADDRESS: (state, county,town) <br /> AC1 .?j:�, Pebble Valley Court <br /> El Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 9,190 3 N/A (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> (PROJECT DESCRIPTION: <br /> New Construction Home withI Detacted Garage ❑ Zoning District <br /> L <br /> . 0 This project is a new building or strut ur . ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: y,' PERMIT NUMBER: ❑ Rural Address <br /> EW ma <br /> ER I SEPTIC (new/existing) <br /> HEIGHT IN FEET: y� NUMBER OF STORIES: (Not including basement) <br /> 1�)Ko i S.`S 1.0 ❑ Wetland/Flo reland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: 1-1 ErosionControl permit <br /> TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 13 2.L) ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ -s -► and available options. <br /> (Please round to nearest dollar) $ 18,000.00 <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 ao 12 Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ['Yes \Io <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes al <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) Dies ao ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes EINo <br /> ely A.C. APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> (Continue on Back) -♦ ■ —► <br />