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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> • • •. <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Brian D. Ring S` z' 2009 <br /> Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 6646 Cheddar Crest Sun Prairie WI 53590 P variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRE O N I N G DIVISION <br /> (608)837-3760 (608)695-7700 I b)nng4 dtrcharter.rret I►', <br /> Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION :nd includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Same as owner Same as owner 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS .f welUseptic if I •' I <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> I Y <br /> PHONE PHONE Site Plan approval from <br /> pplicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of property <br /> PARCEL NUMBER: CURRENT'ONING: ACREAGE: p le <br /> DPARCEL 0911-293-2610-4 A-1 0.71 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Bristol 29 1/4: SW 1/41/4: NW Imo/ Driveway permi'�, <br /> ADDRESS: state,coun rI• �'• <br /> 6646 Cheddar Crest <br /> CSM: LOT 40 SUBDIVISION BLOCK/LOT Sanitary <br /> Homestead Estates (publ' ,iiiiIM <br /> PROPOSED PROJECT INFORMATION STAFF REVITAI <br /> PROJECT DESCRIPTION: <br /> Shed tl Zoning District <br /> il ) <br /> . 0 This project is a new building or structure. ':1 Permitted Use? 4�j g <br /> DThis project is an addition/alteration to an existing building or structure. J <br /> SANITARY SERVICE: PERMIT NUMBER: P Rural . <br /> EWER [EPTIC new 1" ' 7 <br /> d <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 10.5 1.0 /'Ad Wetland/Floodplain/ <br /> Shoreland (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: EfosionControl permit / , <br /> 144.0 <br /> 0 ,l TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 144.0 Review Location Survey / fr ESTIMATED CONSTRUCTION COST: .4' ♦ Zr00o.00 and available options. <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? :Yes O[ No [Don't know <br /> 2. Is there a wetland or floodplain on or near the property? QYes o DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes DINo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Eyes $lo <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) Dyes Jlo DDon't know <br /> 7. Is this to correct a violation? Dyes ✓DNo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -► -► <br /> 545-112(8/09) <br />