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ZOIING PERNIT U^-11ON wiwtcountyddare.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Todd & April Komplin Zoning Status;CUP; <br /> El OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 1456 Wild Iris St., Sun Prairie, WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 608-834-4500 tkomplin(a�charter.net 0 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Randy Marten Marten Building & Design 0 Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of 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 Plan approval from <br /> 608-212-6934 608-212-6934 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> randNAmartenbuildinq.com randy(c�martenbuilding.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) JElevationofproperty <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> El PARCEL 091119445890 WEI A--` .812 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Bristol 19 IA: SW Ya : SE ❑ Driveway permits <br /> ADDRESS: (state,county,town) <br /> li Ci`/!l O' 10 i, IN- ❑Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 9 Lehmann's Addib 9 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family New Contruction ❑ Zoning District <br /> . (This project is a new building or structure. ❑ Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> FIEWER 7EPTIC 13-2017-0075 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 21-1" 1 ❑ Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) ❑ ErosionControl permit <br /> BASEMENT: 1ST FLOOR: p p <br /> 1'850 2,878 + TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: + 3RD FLOOR: filling/access) <br /> 3,728 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ ♦ —• -+ —• —• $ 392,461.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Eves [ to EDon't know <br /> 2. Is there a wetland or floodplain on or near the property? fees 'lo (Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? [ Yes ENo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes [ No <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) [1Yes ONo ❑Don't know <br /> 7. Is this to correct a violation? Lives ZINo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) <br /> 545-112(4/08) <br />