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ZONING PERMIT APPLICATION ww .countyofdane.com SUPPLEMENT to Web-App # <br /> w <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME i <br /> 4fnmy i <br /> • r t r cl.S ' I ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1-660-Vineyard-Bi—.cegon,wi 9575 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Daniel Waldner Same As Agent ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> P 0 Box 1103 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Sun Prairie Wi 53590 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 235-4371 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> danieljwaldner @yahoo.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ID of property <br /> ❑ <br /> PARENT /P�ARCELNUMBIER:1 (� ( CURRE �NING ACRElrE:� frontage drawn to scale. <br /> NUMBER v S I�— J� pl /18 ��� ' ���)I <br /> TOWNSHIP: SECTION: '1_ \\ <br /> Town Of Dunkirk ! D '/4: (� IA '/a'A: s v V ❑Driveway permits <br /> ADD ESp (state,county,town) <br /> 2k ( ( Marilyn Drive <br /> ['Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> )4 Z . , , t N/A (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Home Construction %vtc IL 'LL a iii\ ® 1 ❑ Zoning District <br /> 0 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: ❑ Rural Address <br /> EWER [EPTIC ('3 - a 0/ L- D 0/ N (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 22.0 1.0 ❑ Wetland/Floodpiain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ❑ ErosionControl permit <br /> BASEMENT: 1,801 .0 1ST FLOOR: 3,109.0 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> v filling/access) <br /> 2ND FLOOR:0.0 3RD FLOOR:0.0 <br /> 4,910.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ $ 290,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes Jo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes Erlo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? [Yes ao <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes Jo <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) Dies D. ['Don't know <br /> 7. Is this to correct a violation? ❑Yes EINo <br /> _,.....W LI APPLICATION MUST BE SIGNED <br /> 545-112 taioe> I� (Continue on Back) <br />