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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 /> Tumbledown Developement Company Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zp) Deed Restriction;CSM <br /> 7664 Tumbledown Trails Verona WI 53594 Variance(# ) <br />- HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)849-6770 (608)576-7240 jeanette@premierbuildersinc.com Q Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jeanette Acker Premier Builders Inc. D Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 102 N HOliday Drive 102 N Holiday Drive <br /> (City,State,Zp) (City,State,Zp) tbacks <br /> Waunakee WI 53597 Waunakee WI 53597 <br /> PHONE PHONE ite Plan approval from <br /> (608) 849-6770 (608) 849-6770 applicable township. l <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jeanette @premierbuildersinc.com jeanette@premierbuildersinc.com [-Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) i'Q-" property <br /> tion of r0 PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: t� <br /> n PARCEL 03810708-293-2188-0 A - ( o 69 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: ` ..Drweway permits (J' <br /> Middleton 29 1/4: nw 1/41/4: sw (state,county,town) <br /> ADDRESS: <br /> 5 I �^1 b �d6 w n T-r anitary permits <br /> CSM: LOT 8 SUBDIVISION BLOCK/LOT b ' <br /> 1 <br /> C7 Tumbledown Farms (public,private) <br /> I PROPOSED PROJECT INFORMATION REVIEW <br /> PROJECT DESCRIPTION: <br /> New Home Construction Q Zoning District <br /> . F This project is a new building or structure. tt Permitted Use? <br /> This project is an addition/alteration to an existing building or structure. � <br /> SANITARY SERVICE: PERMIT NUMBER: EC KR r!Address <br /> (EWER (7EPTIC '3 - all%-0003a 40,-xisting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 7 / 61( 2.0 L.-Wetland/Floodplain/ U`C <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> Li-ErosionControl permit <br /> BASEMENT: 11687.0 1ST FLOOR: 2,917 0 1 TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, ,6 <br /> 2ND FLOOR: 3RD FLOOR:L v7 ♦ filling/access) <br /> 1 ,414.0 6,018.0 <br /> CI-Review Location Survey U ,i <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ -► ♦ ♦ $ 450 000.00 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? Dyes Olo rpon't know <br /> 2. Is there a wetland or floodplain on or near the property? Dyes o IS Don't know <br /> 3. Have you talked with the township about your project and are they in agreement?.... :lees Oo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Dyes ✓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) Dees DNo ODon't know <br /> 7. Is this to correct a violation? Dyes ✓�Vo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ -i —► <br /> 545-112(4/08) <br />