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ZONING PERMIT APPLICATION www.counofdang.com rl'"1/"4■ 14',t1.1•.f1iMAjsra <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME Nathan and Caitlin Weitzel <br /> 12/Zoning Status; CUP; <br /> o6 gRfrtEroveugtreetet14eedst urg, WI 53959 Deed Restriction; CSM <br /> Variance(# ) <br /> HOM H E <br /> 6 - t�3-3528 CE g0P O 3t3-1564 E-MAIL ADDRESS cbrittg @yahoo.com El/Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME `ha "iari Welfzel <br /> EfiSite Plan including location <br /> AGENT ADDRESS CQ4T�C�TO8ADDRESrove 5$treet of well/septic <br /> �(jj �5 ryry <br /> (City,State,zip) ( star , ip) I'etbacks <br /> eec� &rg, WI 53959 <br /> PHONE PHONE Site Plan approval from <br /> 608-393-1564 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRE S. <br /> cbrittg @yahoo.com Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT P CURRENT ONI G: AC Elevation of property <br /> ElPARCEL � .43-4222-0 -1�1 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECT N: SW Q Driveway y permits <br /> ADDRESS: Lot 12 Amethyst Drive, Waunakee, WI 53597 ( te,county,town) <br /> CSM: LOT LOT BD(VISI N BLOCK/LOT Sanitary perm t 142., /�12 ' 'prmg field Ridge (public, private) l�� <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> P pJE T D SCRI TION: <br /> Sgingie ramlly residential LiZoning District �I <br /> Q This project is a new building or structure. 'raft�c <br /> ❑ Permitted Use? iy <br /> This project is an addition/alteration to an existing building or structure. p_ <br /> SANITARY SERVICE: PERMIT NUMBER: 13-2016-00065 CI RuralAddress ^`'`�1 <br /> [)EWER JEPTIC (new/existing) &De` <br /> HEIGHT IN FEET. 25 NUMBER OF STORIES: (No including basement) ❑ t( OOd lain/ <br /> p <br /> 4)54.: AREA TO NEAREST SQUARE FOOT: Sh an (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT. 3,048 1ST FLOOR: [. <br /> ❑ Eros' of permit j.'' <br /> > > '.5 IL.' + TOTAL SQUARE FOOTAGE: j (sf ,di rbance, 19 <br /> filling/acce ) / <br /> 2ND FLOOR: 3RD FLOOR: <br /> SV�\/'^ Wi eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: e2 �, ^ }. and available options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ -. -♦ '♦ S /e,/`(�4 > <br /> no <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ✓ Jo �on't k <br /> 2. Is there a wetland or floodplain on or near the property? Ekes ,/No DDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? I1Yes No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓DNJo <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 ,/No fDon't know <br /> 7. Is this to correct a violation? ❑Yes ./No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -* <br /> cds_tt,,(4/(P\ <br />