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F <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Johnny & Christy Waldner <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> Oning Status; CUP; <br /> P 0 Box 1103 Sun Prairie W 53590 Deed Restriction; CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL AEiDRESS <br /> (608)444-7706 (, Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Daniel Waldner Waldner Construction Inc lErite Plan including location <br /> AGENT ADDRESS CONTR4TOR ADDRESS of well/septic <br /> 6692 Covered Bridge Trail 6692 Covered Bridge Trail <br /> (City,State,Zip) (City,State,Zip) [V Setbacks <br /> Sun Prairie W 53590 Sun Prtairie Wi 53590 <br /> PHONE PHONE Site Plan approval from <br /> (608) 235-4371 ! (608) 235-4371 applicable township. <br /> E-MAIL ADDRESS E-MAIL A[DRESS <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 TING: ACREAGE: 0 Elevation of property <br /> lig PARCEL <br /> NUMBER 0911-194-9581-6 n, -, 1.11 a1. frontage drawn to scale. <br /> TOWNSHIP: SECTION:1 (� <br /> Town Of Bristol 19 I/: ,%/4: `9�-1 Driveway permits <br /> (state, county,town) <br /> ADDRESS:' - Pebble Valley Court <br /> CSM: LOT SUBDIVISION BLOCK/LOT Sanitary per its <br /> 9,190 3 N/A (publi ;prlvat- <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT nFCCRIPTIC)N' <br /> fNew Construction Home)with(Detacted Garage I ��( ( t:Q() - iiti-ry,itl ❑ Zoning District <br /> . IN This 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: ❑ Adress <br /> EWER PEPTIC 1 3- I O I ,- v Q a, 8 <br /> xisting) <br /> HEIGHT IN FEET: NUMBER QF STORIES: (Not including basement) <br /> 23.0 1.0 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: ErosionControl permit <br /> 2,037.0 3,455.0 4 TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 5,492.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: i ♦ i -i and available options. <br /> (Please round to nearest dollar) $ 305,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes 0Jo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? 0Yes ao Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Efres 'lo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Yes Elo <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) ✓QYes ao ❑Don't know <br /> 7. Is this to correct a violation? ' 1 :Yes Jo <br /> 1. I 1. C \ t APPLICATION MUST BE SIGNED <br /> 545-112(4/08) ( <br /> �� \ (Continue on Back) -► <br /> '� <br /> , l <br />