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0 (41 66 40- 7, 0650011 ( ---(1 . � <br /> ZONING PERMIT APPLICATION www.countyotdane.com SUPPLEMENT to MlsbtiApp A <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> O'ANER.NAME <br /> Phil & Becky Sautebin <br /> ___-___....... ❑Zoning Status;CUP: <br /> OWNER ADDRESS (Number,Street.City.State,Zip) Deed Restriction;CSM <br /> 6516 Harvest Moon Ct Waunakee WI 53597 Variance(# ) <br /> HOME PHONE 'CELL PHONE jE-MAIL ADDRESS <br /> (608)332-0206 sautebinp @hammescosports.com C Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders,Inc. <br /> _ _ r_:1 Site 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) 0 Setbac (" <br /> Waunakee WI 53597 Waunakee WI 53597 <br /> PHONE PHONE ❑Site Pla p om <br /> (608) 849-6770 (608) 849-6770 applica n ip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jeanette.acker @tds.net jeanette.acker @tds.net ,_ Floor plans to scale 1° <br /> PROPERTY/LOCATION INFORMATION (http://sccossdane.co.dane.wLusl) O <br /> PARENT PARCEL.NUMBER. CURRENT ZONING ACREAGE 0 Elevation of property <br /> CPARCEL 0909-363-2121-0 ' l frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Vienna 36 1/4: SE 1/41/4: SW ❑Drive r,i�. - <br /> AoDRESS• (state,co t t. n) <br /> 6516 Harvest Moon Ct <br /> CSM I SUBDIVISION BLOCKiLOT ❑Sa / -ry•4Y its <br /> i LO' <br /> 23 I Nature Valley Conservancy (pu'.lic, r r` S7 <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION' <br /> Screen Porch& Deck Addition iJ Zoning Cki rict <br /> . <br /> This project is a new building or structure. <br /> ❑ PermitttZse? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE PERMIT NUMBER. U Rural Ad• - s <br /> I3EWER EPTIC (new/ext-31l.. <br /> HEIGHT IN FEET Not NUMBER OF STORIES (Not encluding basement) <br /> l� ❑ Wetla o lain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shor I nd attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) U Erosion a of permit <br /> BASEMENT 1ST FLUGR � I 1 TOTAL SQUARE FOOTAGE: , (sl0 •I bance, <br /> ----------._....._ - fillin. access) <br /> 2ND FLOOR 3RD FLOOR: n Q O <br /> LV ❑ Rew ;.ati•n Survey <br /> ESTIMATED CONSTRUCTION COST: and a i • q tions. <br /> (Please round to nearest dollar) -+ .4. -I' -+ -' '' $ 20,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Yes ENo ©Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Des 4No Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Des •No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? nYes IS 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) QYes ❑No Ez Don't know <br /> 7. Is this to correct a violation? QYes r4No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(aroei (Continue on Back) -► -- <br /> (Continue <br /> NWPAL- ikd A 5k. (eCtl -777 <br />