Laserfiche WebLink
_ . 1 <br /> ZONING PERMT APPLICATION www.countyofdane.com SUPPLEMENT to wn.b.App r <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> . OWNER NAME <br /> 14 P f 1-P Prop�i� It/( <br /> Zoning Status;CUP; <br /> OWNERAf,D lDRE S (Number,Street, ity.Sstate,Zip) { � Deed Restriction; CS:11 <br /> ).C5 Utkho 3, vt,, f--t 300 N tk11W, OA 04J-/ {� Variance(# ) <br /> t'tQME PH'1�'E� I CELL PHONE E-MAIL ADDRESS <br /> OOl ^ ,(xr"i - q 38''I 0 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NE <br /> Glans.Pyle.Schomer,Bums&DeHaven,Inc-Cynthia Nokle "r Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 5595 Transportation Blvd.Suite 100 <br /> (City,State,Zip) (City,State,Zip) - ❑Setbacks <br /> Cleveland,OH 44125 <br /> PHONE PHONE ❑Site Plan approval from <br /> (216) 927-8649 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> cnolde @gpdgroup.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accre wt ja) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> 0 PARCEL 014/0810-081-9920-5 C-2 10.20 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> TO8NR1OE 8 I/: SE 1/4/4: NE ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 5901 US Highway 51, DeForest, WI <br /> CSM: 1 LOT I SUBDIVISION BLOCK/LOT n Sanitary permits <br /> i <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Replace Country Pride Restaurant with Popeyes. Relocate Subway within QSR space. J Zoning District <br /> . OThis 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: LI Rural Address <br /> EWER [EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 21.4 2.0 J Wetland/Floodplain! <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: J <br /> ErosionControl permit <br /> 12 395.0 4, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/access) <br /> 16,427.0 . J Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ .4. and available options. <br /> (Please round to nearest dollar) $ 625,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Dyes ONo ©Don't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes alo FjDon't know <br /> 3. Have you talked with the township about your project and are they in agreement? ✓[]Yes ['lo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? []Yes [lo <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) Des ©•o ]Don't know <br /> 7. Is this to correct a violation? Des ✓�No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(41D8) <br /> (Continue on Back) -+ —► --o, <br />