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ZONNG �I APPLICATION e. ' <br /> Vwico SUPPLEMENT to Web App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Jason Ledford oning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> • 3047 Midnight Sun Dr. Variance(# ) <br /> V HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 576-0462 jason.ledfordcharter.net 1 ,...94e-Plan drawn to scale <br /> AGENT INFORMATION ICONTRACTOR INFORMATION andlnclu s dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten Marten Building & Design ' e Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/s <br /> P.O. Box 64 P.O. Box 64 <br /> (City,State,Zip) (City,State,Zip) Se acks <br /> Sun Prairie, WI 53590 Sun Prairie, WI 53590 <br /> PHONE PHONE ❑Site proval from <br /> 608-212-6934 608-212-6934 applic a wnship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randy&martenbuilding.com randy(a�martenbuilding.com FI r plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.ust) Vatlonof property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p p y <br /> ❑PARCEL 0911-192-0568-C) A-1 1.01 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Bristol 19 1/4: NW 1/41/4: NE Driv- .y ..-rmits <br /> ADDRESS: (state • nty,town) <br /> 3047 Midnight Sun Dr ' <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 18 Sam•: :' Its n <br /> Norway Road Ed 18 (pip. c, • 'vats) I lJ a A <br /> PROPOSED PROJECT INFORMATION S FF REVIEW <br /> PROJECT DESCRIPTION: •e5 AC -la cn(t- <br /> )4)-114 <br /> -p•,, __= t_ 01 Alt. A p.., ;a <br /> District <br /> . ZThis project is a new building or structure. ermitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural ' `• ` <br /> FIEWER r)EPTIC (new 40' <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 14'-8" <br /> AREA TO NEAREST SQUARE FOOT: Shor attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: Ero C011tr m11t <br /> 224.00 4, TOTAL SQUARE FOOTAGE: 4, (slopes rbance, <br /> filli secs <br /> 2ND FLOOR: 3RD FLOOR: <br /> 224.00 Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) -4.. ♦ --0. -la 5,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes aio ❑Don't kno <br /> 2. Is there a wetland or floodplain on or near the property? ['Yes 7lo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? IYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes lalo <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) [2]Yes Ilo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes ZJo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -. —► -. <br /> 545-112(4/08) <br />