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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 /> Dan Blaschka <br /> OWNER ADDRESS (Number,Street,City,State,Zip) 0111ng Status;CUP; <br /> 1704 Clardell Drive Sun Prairie WI 53590 Deed Restriction;CSM <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 (608)849-6770 jeanette.adcer@tds.net ite Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders Inc lasi a Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS ofwellse tic <br /> 102 N Holiday Drive 102 N Holiday Drive <br /> (City,State,Zip) (City,State,Zip) tbacks <br /> Waunakee WI 5359 Waunakee WI 53597 • <br /> PHONE PHONE []Site n royal from <br /> (608) 849-6770 (608) 849-6770 appli township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> jeanette.acker@tds.net jeanette.acker@tds.net loor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.diane.wi.us/) <br /> PARENT PARCEL NUMBER: C,1 RRENTZONING: ACREAGE vation of property <br /> rii PARCEL 0811_343-0583_0 J_ ' 'Q / frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: ECTION: n�. <br /> Sun Prairie 34 %/; NE +%+A4, SW riveway pe /"—' <br /> ADDRESS: ' <br /> (state,coun ,town) ` <br /> '�S Oh n Q AS C r anita ..-...its <br /> CSM: LOT SUBDIVISION BLOCK/LOT S <br /> 13,747 1 (publi • private e%/Q <br /> PROPOSED PROJECT INFORMATION <br /> OF-REVIEW <br /> PROJECT DESCRIPTION: <br /> 1/r) / �, o g District <br /> • 4 This project is a new building or structure. ermftted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: UralAddl'> ss <br /> FIEWER PEPTIC -3/ /S _T I (existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 30.0 2.0 II e i , e e plain/ <br /> AREA TO NEAREST SQUARE FOOT: '' i ent) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ®I EroSlonControl permit • ii( <br /> BASEMENT: 1ST FLOOR: p <br /> 3,307.0 4,675.0 j TOTAL SQUARE FOOTAGE: + (slopes,disturbance, A <br /> 2ND FLOOR: 3RD FLOOR: full access) <br /> 1,185.0 9,983.0 <br /> ESTIMATED CONSTRUCTION COST: evieW Location Survey <br /> (Please dollar) ♦ ♦ ♦ -' .- ♦ $ 700,000.00 andavailatit s <br /> Please round to nearest doElar <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? I]✓Yes QNo QDon know_ <br /> 2. Is there a wetland or floodplain on or near the property? [Yes Bo QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes o <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Yes ✓N° <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) Ekes pia 4Don't know <br /> 7. Is this to correct a violation? []Yes ✓[]No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) —► —► —► <br />