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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 /> Stephanie & Kevin Kleckner <br /> IN Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 994 Chandler Lane,Sun Prairie,WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)225-4594 ambiancehomesinc @charter.net F Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Ambiance Homes Inc Ambiance Homes Inc Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 994 Chandler Lane 994 Chandler Lane <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks <br /> Sun Prairie,WI 53590 Sun Prairie,WI 53590 <br /> PHONE PHONE IN Site Plan approval from <br /> (608) 225-4594 (608) 225-4594 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ambiancehomesinc @charter.net ambiancehomesinc @charter.net 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: 12 Elevation of property <br /> ['PARCEL 058/0811-123-4128-0 R-1 DCPREZ-0000-08249 1.02 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Sun Prairie 12 14. sw .1/41�4. sw 4 Driveway per.-' <br /> ADDRESS:J� (state,count ,town) <br /> S O3 3 Grassland Terrace <br /> IN Sanitary -. ' <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 14,162 1 Savannah Valley (public private <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: ,,� <br /> Single Family Residential I� Zoning District <br /> . This project is a new building or structure. leDermitted Use? <br /> This project is an addition/alteration to an existing building or structure. �-� <br /> SANITARY SERVICE: PERMIT NUMBER: !1Q '.� - Address <br /> FIEWER SEPTIC 13,201,600,022 -xisting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 34.0 2.0 Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: <br /> Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ' ` ErosionControl permit <br /> 2,495.0 i�95.0-'--5 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> ` filling/access) <br /> 2ND FLOOR: 820.0 3RD FLOOR: 0.0 <br /> O -r 3 ciReview Location Survey t C <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ --► ♦ ♦ and available options. k-.40(Please round to nearest dollar) $ 315,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes oNo DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? DYes ao ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes IENo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dyes ✓D 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 Qldo DDon't know <br /> 7. Is this to correct a violation? Dyes ao <br /> _ APPLICATION MUST BE SIGNED <br /> sastt2laroa> (Continue on Back) ♦ —0 —I. <br />