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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Capitol Investments, Inc zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street.City,State,Zip) Deed Restriction;CSM <br /> ` 13845 Bullard Rd Evansville WI 53536 Variance(# ) <br /> �/ HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 jeanette.acker@tds.net drawn to scale <br /> AGENT INFORMATION 1 CONTRACTOR INFORMATION and includes 9.--nsions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders,Inc. ite Plan including location - <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 02 N Holiday Drive <br /> X1 102 N Holiday Drive <br /> `J/{City,State,Zip) (City,State,Zip) P etbacks <br /> Waunakee,WI 53597 Waunakee WI 53597 <br /> PHONE PHONE p Site a royal from <br /> (608) 849-6770 (608) 849-6770 appli wnship. <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://accessdane.co.daneawLus/) tl <br /> PARENT PARCEL NUMBER: RRENTZONING: ACREAGE: vaon of property <br /> ©PARCEL 0811-123-4188-0 // l'Y 1 2 fr.a _•- drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: f eway per Prairie 12 Y: SIN WA: SW e er <br /> V ADDRESS: - _ ` • •I,`) <br /> Q �� V,I e op Sanitary pe-�csM r SUBDIVISION BLOCK/LOT <br /> 18 Savannah Valley `public,private) PJ if/ <br /> PROPOSED PROJECT INFORMATION S .1 . - ., <br /> PROJECT DESCRIPTION: <br /> new home construction Zoning District <br /> This project is a new building or structure. ,,u�,, 5.----� <br /> tL' elTnitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE. PERMIT NUMBER: • -I AddreSS <br /> new .xjstin <br /> EWER �EPTIC '� ��01/S n83J 08- 1'f--+ ( g) <br /> HEIGHT IE9 NUMBER OFSTORIES: (Not including basement) <br /> 04 TORIES: <br /> 1= plain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Sho ttachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> Eros trot permit <br /> BASEMENT: 1,856.0 1ST FLOOR: 3,360.0 T TOTAL SQUARE FOOTAGE: j (slope ,di ance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> fillin cress) <br /> 868.0 6,075.0 eview Location Sum•. <br /> ESTIMATED CONSTRUCTION COST: -► -► -s ♦ -► ��! nd availableop •s, <br /> (Please round to nearest dollar) l y' _ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes VIVO (Don't now <br /> 2. Is there a wetland or floodplain on or near the property? nYes t3"" QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? es []No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? QYes Elm- <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 ONo GM-tic-know <br /> 7. Is this to correct a violation? QYes <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) --► -► —► <br /> 545-112{4708) <br />