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.. 7 q7. 3 <br /> Y <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> 01NNERNAME PAUL R STITELEY <br /> ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Restriction; C$ <br /> 85 <br /> Rt <br /> Deed II <br /> Variance Deed R t <br /> 7828 CARIBOU CT,VERONA,WI,53593 ) <br /> HOME PHONE CELL PHONE E•MAILADDRESS <br /> 513-7828 PAULSTITELEY @YAHOO.COM (Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and inctdes d' ensions <br /> AGENT NAME CONTRACTOR NAME <br /> KYLE ACKER PREMIER BUILDERS Site Plan 4Iuding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 102 NORTH HOLIDAY 102 NORTH HOUDAY <br /> (City,State,Zip) (City,State,zip) E!Setbacks <br /> WAUNAKEE,WI,53597 WAUNAKEE,WI,53597 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 849-6770 (608) 849-6770 'applicable tpwns hip. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> KYLEACKER.PREMIER @GMAIL.COM INFO@PREMIERBUILDERS.COM El Floor pl <br /> PROPERTY/LOCATION INFORMATION (http:paccessdane.co.dane.wi.us?) <br /> PARENT PARCEL NUMBER: CURRE ACR ❑Elevation of property <br /> ❑PARCEL 25 ( r�2- frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTIO : <br /> 25 +/4: NW %%: NW ❑Drivewa .:4/q � <br /> (state,co I n <br /> ADDRESS: 7828 CARIB l 5133 w . (NCI d I Sanitary Its <br /> CSM: LOT BDMSION BLOCK/LOT • <br /> 13,897 3 (Public,p ' ate) <br /> PROPOSED PROJECT INFORMATION ;.';STAFF:REVIEW . <br /> PROJECT DESCRIPTION: - ' <br /> NEW CONSTRUCTION 1-o ning D t <br /> . 51 This project is a new building or structure. . Perm ? <br /> ❑This project is an addition/alteration to an existing building or structure. (p . t t <br /> SANITARY SERVICE: PERMIT NUMBER: Q RU 'I ddres8 <br /> (EWER PEPTIC }} II �° Wo ,,.0 _ xisting) •HEIGHT IN FEET: NUMBER OF STOR �(N dudtng basement) .•e% 25.0 1.o 0 Wetla` ;, ';�,,plalri! <br /> AREA TO NEAREST SQUARE FOOT Shore?. �, rrlertt) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> 0 EroSienCo ■ •Iperfilt <br /> 3,864.0 6,103.0 + •TOTAL SQUARE FOOTAGE: 4, {dopes,,.' tats'. <br /> tilling/access) ' <br /> ' <br /> 2ND FLOOR: 3RD FLOOR: /']c � : ' <br /> v 0 Review:Location Survey: • <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ $ and available options . <br /> (Please round to nearest dollar) <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes jlo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Des [,/No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes Oho <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ✓❑•o <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 EINo DDon't know <br /> 7. Is this to correct a violation? ❑Yes ao <br /> APPUCATION MUST BE SIGNED <br /> (Continue on Back) -4. -+ -► <br /> 545.112(408) <br /> ' <br />