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ZONING PEWIT APPLICATION wuwuoou,tyortdanaoom �1�' J,�;I ;,•{'.` ' , ' _' <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME Craig and Emily Engstrom <br /> 15 Zoning Status; CUP; <br /> 2648ADungarvan`'I raet' itC itburg, WI 53711 Deed Restriction; CSM <br /> Variance(# ) <br /> HOM PH NE CELL PHONE E-MAILADDRESS <br /> 608-�L13-2582 608-213-2582 Grgig Engstrom @summitcreditunion.co <br /> vi Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> t rris Schmidt cetassic tl-omes of Madison, LLC <br /> Site Plan including location <br /> T RESS C NT TOR ADDRES of well/septic <br /> ig � inpoche Lane 6�59Inpoche Lane <br /> bttr'egto(11 P)W 1 53575 (cureg o )WI 535n75 0 Setbacks y; <br /> PHONE PHONE ❑Site Plan appro(ial from <br /> 608-206-0492 608-206-0492 applica'township. <br /> E-MAIL ADDRESS E-MAIL ADDRE S <br /> schmidtc @charter.net schmidtc @charter.net IS Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wLus/) Elevation of property em PARENT PAR M CURRENT ZONING: AC E' <br /> 8❑PARCEL � � -� 4-6012-1 A-1 I frontage drawn to scale. <br /> NUMBER i <br /> TOWNSHIP: SECTI N (�� <br /> • Town of Middleton ,/4: J--� 1/41/: ❑Driveway/permits <br /> ADDRESS: 73 Sonnet Drive, Verona WI 53593 (state, unty, town) <br /> 0 Sanitary permits <br /> CSM: LOT 2 DIy IS�QNint Estates <br /> BLOCK/LOT (public, private) <br /> gaDa Po <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> P Q CRIPTION <br /> PgmJE gT fe D am rlly, 2 Story Residential Home /' pC�a- . -0 CCA !� oning District <br /> . <br /> This project is a new building or structure. / Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: 13-2016-00050 ❑ al Address <br /> DEWER EPTIC (ne /existing) /- <br /> HEIGHT IN FEET 31' NUMBER OF STORIES: (Not including basement) <br /> 2 Li Wetland/F dplain/ <br /> Shorel d (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> ❑ ErosionContr ermit <br /> BASEMENT 1956 1ST FLOOR: 3526 TOTAL SQUARE FOOTAGE: j (slopes,di rbance, <br /> ♦ filling/a ess) <br /> 2ND FLOOR: 1442- 3RD FLOOR: 0 6924 <br /> ❑ Review Location Su '- <br /> ESTIMATED CONSTRUCTION COST: and available o tions <br /> (Please round to nearest dollar) ♦ ♦ "� ♦ ♦ '♦ 560,000.00 p �i�J <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes Elio DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? Des ,/No Jon'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? ❑Yes f.lo <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 ,/No DJon't know <br /> 7. Is this to correct a violation? ❑Yes ✓No <br /> tl.„ ...--- 9 , \')--) C APPLICATION MUST BE SIGNED <br /> (Continue on Back) -.► ■ -+ <br /> {aa-i»(AMR, �U <br />