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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT toWelt.ApoN <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Anthony and Julie Bret' <br /> OWNER ADDRESS(Number,Streat,City,state,Z9) ❑Zoning Status;CUP; <br /> Deed Restriction;CSM <br /> 2655 Oak Crest Circle, Sun Prairie, WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE EMAIL ADDRESS ajbretl@wisc.edu -or <br /> 608-837-7916 608-692-7916 jibretl @michaelbest.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION. •• • ••- and includes dimensions <br /> AGENT NAME . CONTRACTOR NAME <br /> ❑Site Plan including location <br /> AGENT ADDRESS CON TRACTOR ADDRESS of well/septic <br /> • (City,State,Zip) (City,State,Zips ❑Setbacks <br /> PHONE PHONE ❑Site Plan approval from <br /> applicable township. <br /> E—MAIL ADDRESS EMAIL ADDRESS <br /> ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:llaccessdane.co.dane.wt.usf) El Elevation of property <br /> PARENT PARCEL NUMBER' cum-ism-ZONING: ACREAGE: <br /> _PAMBER 058/0811-324-9940-5 A-1 (Ex .77 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Town of Sun Prairie y: WA: ❑Driveway permits <br /> ADDRESS: — --°— - (stale,county,town) <br /> 2655 Oak Crest Circle, Sun Prairie,WI 53590 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 635 1 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> ❑ Zoning District <br /> ©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: ❑ Rural Address <br /> nsEWER FTC EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 15-16' ❑ Wetland/F000dplain/ <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: ❑ ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: _ i i y --► r.'''' 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 N. ['Don't know <br /> 2, Is there a wetland or floodplain on or near the property? [Yes x o ❑Don't know <br /> ❑ <br /> 3. Have you talked with the township about your project and are they in agreement? Yes No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ❑X h 10 <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) ❑Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes EINo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —say-t+2 WOO) <br /> —0- <br /> .Paki(I Q CA. PPM( . "I .V5' <br /> DRN eveayoe`i 211'1591 <br />