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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Judy and Clark Langley ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> Muller Road,Town of Bristol,WI Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)250-9164 <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Kennan Crothers Voyager Builders ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1500 W Main ST 1500 W Main St <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Sun Prairie,WI 53590 Sun Prairie,WI 53590 <br /> PHONE ❑(608) 444-2742 PHONE (608) 444-2742 applicable approval nship . <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> kennan @voyagerbuilders.com kennan @voyagerbuilders.com ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑NUM ER c')?/1 I5-2.6 Po v A--I 1.13 frontage drawn to scale. <br /> TOWNSHIP SECTION: <br /> Bristol .1/4. '/1/4. ❑ Driveway permits <br /> ADDRESS: (state, county,town) <br /> 22Is- Muller Road <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 14,333 1 (public,private) <br /> coPROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Custom ranch home with outbuilding ❑ Zoning District <br /> . Ig 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: Li Rural Address <br /> EWER [EPTIC 1,3 - 1(, - 0 o 3 Y 3 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 21.5 1.0 ❑ Wetland/Floodplain/ <br /> Shuretand (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ <br /> ErosionControl permit <br /> 1,260.0 2,124.0 4, TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: 3,384.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) -+ ♦ ♦ ♦ ♦ ♦ $ 255,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes FINo ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes 19No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑i/Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ['Yes igNo <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 IgNo ❑Don't know <br /> 7. Is this to correct a violation? Dies igi No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -+ -► <br /> 545-112(4/08) <br />