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SUPPLEMENT to Web-App# <br /> ZONING PE RMT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION <br /> OWNER NAME CUSTOMER TO PROVIDE <br /> TRENT STONEROOK <br /> OWNER ADDRESS (Number,Street,City,State,Zip) ❑Zoning Status;CUP; <br /> 600 CAMP STREET,BARABOO,WI 53913 Deed Restriction;CSM <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Variance(# ) <br /> (720)984-8496 trent.kristie @hotmail.com <br /> AGENT INFORMATION ❑Site Plan drawn to scale <br /> CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dan Beal CRAFTSMAN CONSTRUCTION <br /> AGENT ADDRESS ❑Site Plan including location <br /> CONTRACTOR ADDRESS of well/septic <br /> 600 CAMP STREET 600 CAMP STREET <br /> (City,State,Zip) (City,State,Zip) D Setbacks <br /> BARABOO,WI 53913 BARABOO,WI 53913 <br /> PHONE PHONE D Site Plan approval 356-2332 pprnshi from <br /> ( (608) 356-2332 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jeremy@craftsmanbuilding.com Jeremy @craftsmanbuilding.com D Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accossdane.co.ckane.wi-ust) <br /> ❑PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: D Elevation of property <br /> PARCEL 012/0911-303-2060-0 <br /> NUMBER _ 0.7e frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> TOWN OF BRISTOL 30 1/4. NW 1/41/4: SW 1:1 Driveway permits <br /> ADDRESS: (state, county,town) <br /> 6669 JERRY RYAN TRAIL <br /> CSM: LOT 30 SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> BRISTOL GARDENS (public,private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: STAFF REVIEW <br /> NEW RESIDENTIAL SINGLE FAMILY ❑ Zoning District <br /> • tg This project is a new building or structure. <br /> ['This project is an addition/alteration to an existing building or structure. ❑ Permitted Use? <br /> SANITARY SERVICE: PERMIT NUMBER: `�j Rural Address <br /> EWER PEPTIC 13�- U 2.015�Oa Z 8 / (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 32.0 2.0 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: 1--1 <br /> ErosionControl permit <br /> 'W5 1,606".5...1.447/S1 3,230.0 ,j, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 1,650.0 1 3RD FLOOR: II ,n(� Q v•0 filling/access) <br /> 1 LO l6 <br /> ESTIMATED CONSTRUCTION COST: ❑ Review Location Survey <br /> (Please round to nearest dollar) <br /> -0. -• -0 -0- -N. 560,000.00 and available options. <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes OW ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? <br /> Dyes @ o []Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? D✓Yes Vo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dyes ✓No <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) Yesfo DDon't know <br /> 7. Is this to correct a violation? Dyes ao <br /> i g APPLICATION MUST BE SIGNED <br /> C <br /> 545-112 W081 : f - -S X (Continue on Back) -► -i -0' <br />