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640, 1 ) <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> James Muir <br /> 0-ruling Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> f 815 Clarkson Rd,Marshall WI 53559 Variance(# ) <br /> v HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 (608)849-6770 jeanette.acker @tds.net lasliii7lan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders Inc a Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 102 N Holiday Drive 102 N Holiday Drive �--_ <br /> (City.State,Zip) (City,State,Zip) ["Setbacks <br /> Waunakee WI 5359 Waunakee WI 53597 <br /> �\\JJJI PHONE PHONE 0 Site n proval from <br /> (608) 849-6770 (608) 849-6770 appli ownship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS < <br /> jeanette.acker @tds.net jeanette.acker @tds.net oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:l/accessdane.co.dane.wl.usl) Jevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P p rty <br /> ©PARCEL 0811-172-8560-0 2 frontage drawn to scale. <br /> NUMBER 1 , CI Ca-71 7. j g <br /> TOWNSHIP: SECTION: <br /> Sun Prairie 17 l/; Nw %1/, SW Driveway permits <br /> (state,coun ,,#ow) <br /> V<DDRESS: _ ._ � <br /> vvvYYY 4 .14/{ Dee_r C ,re�k is jn J <br /> Sanitary pe its <br /> CSM: 11,221 LOT 1 SUBDIVISION BLOCK/LOT (public priva <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESC'IPy, , : ' <br /> .1/. Art / & IV/f Zoning District <br /> ©This project is a new building or structure. <br /> rrnitted Use? <br /> This project is an addition/alteration to an existing building or structure. � � <br /> SANITARY SERVICE: PERMIT NUMBER: '+A al Address <br /> EWER EPTIC Q (new -xisting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> I'l •S - 2.0 LI Wetlan, Floodplain <br /> -- Shorelan: - - -nt) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached ga"ages and above grade decks or porches) <br /> Li ErosionCo trot permit <br /> BASEMENT: 1ST FLOOR: /J <br /> 2,298.0 3,$45.0 4,, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance,4,, `-/�/ <br /> 2ND FLOOR: 3RD FLOOR; fillip access} <br /> 1,468.0 7,611.0 ti <br /> Review Location Survey V` o <br /> ESTIMATED CONSTRUCTION COST: <br /> -► -► -► -. -► -► $ 3 ,� . , and avails le options. 4 <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? QYes [No D n know�'� <br /> 2. Is there a wetland or floodplain on or near the property? [Yes D•o [Don't know <br /> 3. Have you talked with the township about your project and are they in agreement?__ [Yes Q✓Nlo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes ©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) Elves [No E4Dan't know <br /> 7. Is this to correct a violation? [Yes ©No <br /> APPLICATION MUST BE SIGNED <br /> 1t2(4108) (Continue on Back) -+ -+- -s <br />