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0 ti <br /> ZON1G APPLJCATIONVl 0u7tyoit doom SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Paul & Julie Bishop <br /> OWNER ADDRESS (Number,Street,City,State,Zip) ❑Zoning Status;CUP; <br /> 9338 Vista Meadow Dr., Verona, WI 53593 Deed Restriction;CSM <br /> HOME PHONE CELL PHONE Variance(# ) <br /> E-MAIL ADDRESS <br /> 608-518-5403 Pa ul.Bishoptu7,bakertilly.corn D Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRAC-OR NAME <br /> Randy Marten Marten Building & Design D Site Plan including location <br /> AGENT ADDRESS CONTRAC-OR ADDRESS of well/septic <br /> P.O. Box 64 P.O. Box 64 <br /> (City,State,Zip) (City,State,Zip) D Setbacks <br /> Sun Prairie, WI 53590 Sun Prairie, WI 53590 <br /> PHONE PHONE D Site Plan approval from <br /> 608-212-6934 608-212-6934 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randyAmartenbuilding.com randyAmartenbuilding.com D Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: D Elevation of property <br /> D NUMBER 091119300340 A-1 .759 frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Bristol 19 1/a: NE 1/41/4: NW El Driveway permits <br /> ADDRESS: (state,county,town) <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 4 Parker Pass 4 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family New Contruction CI Zoning District A'''1 <br /> This project is a new building or structure. <br /> Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: N101 Rural Address <br /> EWER IEPTIC 13-2016-00206 (4D'xisting) <br /> HEIGHT IN FEET: �� NUMBER OF STORIES: (Not including basement) <br /> 31'-3" 2 't;J Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> Erosion <br /> Control 1ST FLOOR: f✓OrltrOl permit <br /> 1,496 2,615 ,` TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 1,658 5,769 <br /> Review Location Survey,,1 <br /> ESTIMATED CONSTRUCTION COST: ♦ -i ♦ ♦ ♦ ♦ and available options. 1v p <br /> (Please round to nearest dollar) $ 403 251.00 p6ons. lI <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes aio DDon't know <br /> 2. Is there a wetland or floodplain on or near the prope ? Dyes ONO DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? Wfres ao <br /> 4. Has there been a zoning permit issued for this prope in the past 5 years? Dyes ow <br /> 5. Is this project associated with a rezone/CUP/varianc (petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Dyes ZINo DDon't know <br /> 7. Is this to correct a violation? DYes gjlo <br /> 1 <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) ■ ■ -► <br />