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4 . ... <br /> 1G ��CATION 0 OOfll SUPPLEMENT to Web App # <br /> � <br /> PROPERTY OWNER INFORMATION C TOMER TO PROVIDE <br /> OWNER NAME <br /> Brian & Krista Willing <br /> Ii zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) teed Restriction;CSM <br /> 1401 O'Keefe Ave Apt. 215, Sun Prairie, WI 53590 ariance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 920-220-3241 brian.willingagamil.com Ste Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION ndincludesdimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten Marten Building & Design S' Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS well/septic <br /> P.O. Box 64 P.O. Box 64 <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Sun Prairie, WI 53590 Sun Prairie, WI 53590 <br /> PHONE PHONE ❑Site Plana oval from <br /> 608-212-6934 608-212-6934 ap ca township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randyamartenbuilding.com randyRmartenbuildinq.com F r plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn evationof property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P rty <br /> ❑PARCEL 091119300560 G1 1.135 rontage drawn to scale. <br /> NUMBER i <br /> TOWNSHIP: SECTION: • <br /> Bristol 19 1A: E 1/a1/a: SW ❑ Dr eway permits Vv 1 <br /> Re ate,county,town) <br /> ADDRESS: a r k e_c IN /`CSM: LOT SUBDIVISION J <br /> Sanitary permits <br /> 6 BLOCK/LOT Parker Place (. blic,private) <br /> PROPOSED PROJECT INFORMATION °TAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family New Contruction Q fining District <br /> . 171This project is a new building or structure. 0 Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: l Address <br /> EWER PEPTIC 13-2016-00271 (ne /existing) <br /> HEIGHT IN FEET Y/ �2 NUMBER OF STORIES: (Not including basement) <br /> " ' 2 ❑ Wetland/F plain/ <br /> AREA TO NEAREST SQUARE FOOT: Shore d (attaChm <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionCOntr rmit <br /> 1099 2264 ,, TOTAL SQUARE FOOTAGE: ,j (Slopes,di rbance, <br /> filling/a ss) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 1117 4,480 <br /> Li Review 1 <br /> Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -�► -I. -0. and available options. <br /> (Please round to nearest dollar) a 381,078.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes Z 10 ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes aJo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? mYes OW <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ONo <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) [Yes ZNo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes ZNo <br /> 2C0 --, APPLICATION MUST BE SIGNED <br /> 545-112(4/08) <br /> 1 (Continue on Back) -► -► -i <br />