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SUPPLEMENT to Web-App# <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Matthew & Bretni Anderson ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 7141 Kalland Way Sun Prairie,WI 53550 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)335-3605 bretnihammer @gmail.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Scott A.Foley Ultimate Construction,Inc. ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 4827 Pierceville Road 4827 Pierceville Road <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Cottage Grove,WI 53527 Cottage Grove,WI 53527 <br /> PHONE PHONE <br /> ❑Site Plan approval from <br /> (608) 825-4633 (608) 825-4633 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> saf @ultimate-construction.com office @ultimate-construction.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wl.usl) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑PARCEL 014/0810-243-0120-0 R-1 RR-• 2.56 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Burke 24 14: NE 1�4: sw ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 3313 Nelson Road Sun Prairie, WI 53550 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits 4 ER <br /> 15,978 2 Windswept (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Single Family Home 2 BR UNFINSHED BASEMENT ❑ Zoning District <br /> . NI This project is a new building or structure. ❑ Permitted Use? YES <br /> This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ RUralAddreSS EXISTIN 3 <br /> EWER 1EPTIC 13,202,200,344 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> a( .k7 �I� 1.0 ❑ Wetland/Floodplain/ N O <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <125' <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) p it pJ\. E\+VAY <br /> BASEMENT: 1ST FLOOR:3!06 t{v Pi)� ❑ ErosionControl emi <br /> 2,456.0 (,,Omit 244, ' 1 l 0 ,, TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance,BEING <br /> 2ND FLOOR: 3RD FL R: 1 filling/access) <br /> 0.0 0.0 ilp A DDED <br /> ❑ Review Location Survey <br /> ESTIMATED a round CONSTRUCTION COST: ♦ -► ♦ ♦ ♦ 750,000.00 and available options. YES <br /> round to nearest dollar) Y ES <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? :Yes ONo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes EINo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? :Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? :Yes IN 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) Ekes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ©No <br /> $666.20 LOCATION SURVEY CONDITION <br /> APPLICATION MUST BE SIGNED <br /> REV(01l19) (Continue on Back) —► —i. —I. <br />