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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Waldner Construction Inc <br /> " king Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> P O Box 1103 Sun Prairie Wi 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)2354371 danieljwaldner @yahoo.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Same as Contractor Waldner Construction Inc Ite Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> P O Box 1103 <br /> (City,State,Zip) (City,State,Zip) etbacks <br /> Sun Prairie Wi 53590 <br /> PHONE PHONE ❑Site Pla proval from <br /> (608) 235-4371 appli township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> danieljwaldner @yahoo.com F or plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) eVation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p P rty <br /> lig PARCEL 0911-193-0111-0 A-1 0.78 ro drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Town Of Bristol '/a: 1/a'/a: Drivew- •e s <br /> ADDRESS: (S - -, =•• ■,town) <br /> Parker Pass <br /> CSM: LOT SUBDIVISION BLOCK/LOT a Sanitary permits <br /> 11 Packer Place (public,private)vZ71�•/fr <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Home oning District <br /> . MI This project is a new building or structure. yii Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: /� ^ ❑ R Address <br /> EWER �EPTIC +?j act) (0 - V Q d� LQ�'l;, isting) <br /> HEIGHT IN FEET: - NUMBER OF STORIES: (Not including basement) �.�� <br /> 23.0 1.0 ki e) -. .:,.lain/ <br /> fk 5_. l Sh. z : (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> ionCalntrot permit <br /> BASEMENT: 2,043.0 1ST FLOOR: 3,218.0 <br /> v TOTAL SQUARE FOOTAGE: (slopes,disturbance, <br /> fil• access) <br /> 2ND FLOOR:0.0 3RD FLOOR:0.0 5,261 .0 <br /> ieW Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available oPtim . <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ $ 345,000.00 \ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes EINo ❑Don't know V <br /> 2. Is there a wetland or floodplain on or near the property? [Yes "lo ❑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? Dies a <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 DINo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes I=INo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -4 -♦ <br /> 545-112(4/08) <br />