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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 /> Tony and Margaret Arts <br /> 1 I Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 249 Cotton Grass Lane,Walworth,WI 53184 Variance(# ) <br /> HOME PHONE i CELL PHONE E-MAIL ADDRESS <br /> (608)575-3882 TARTS@WHYTERRA.COM n Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> REBECCA KIRST Victory Homes of Wisconsin Iv ' Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> N118W18531 Bunsen Drive <br /> (City,State.Zip) (City,State,Zip) n Setbacks <br /> Germantown,WI 53022 <br /> PHONE PHONE n Site Plan approval from <br /> (262) 252-7100 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> REBECCA.KIRST@VCI-WI.COM n Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wl.us/) n Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 0 PARCEL 01810711-101-2112-0 SFR-08 46,148.00 1.06 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Cottage Grove 10 1/4: NW 1/4: NE n Driveway permits <br /> (state,county,town) <br /> ADDRESS: <br /> 2231 WOODED RIDGE TRL 0 Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT (public,private) 4 BEDROOM <br /> 2 Kennedy Hills <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Single Family Dwelling ill Zoning District <br /> . [This project is a new building or structure. 421 Permitted Use? <br /> [This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: V Rural Address <br /> EWER 1EPTIC 13,202,100,165 (new/existing) NEW <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 29' 9" 1.0 cd Wetland/Floodplain/ <br /> — Shoreland (attachment)NO <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) n ErosionControl permit <br /> BASEMENT: 35 <br /> 039.0 1ST FLOOR: 4,318.0 <br /> ,, TOTAL SQUARE FOOTAGE: 4. (slopes,disturbance, NO <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: 7357 <br /> '370 V Review Location Survey Y E S <br /> ESTIMATED CONSTRUCTION COST: -► 708 515.13 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 1/INo [Don't know <br /> 2. Is there a wetland or floodplain on or near the property? YesNo ODon't know <br /> 3. Have you talked with the township about your project and are they in agreement? [✓Yes nNo <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) YES es 1No [Don't know <br /> 7. Is this to correct a violation? Yes [No <br /> $785.70 APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ -+ -► <br /> REV(01119) <br />