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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION <br /> CUSTOMER TO PROVIDE <br /> OWNER NAME Tom Jacobs- Jacobs Cooperage LLC []Zoning Status;CUP; <br /> Deed Restriction;CSM <br /> OWNER ADDRESS(Number.Street,City.State,Zip) Variance t <br /> 6204 S Highlands Avenue-Madison,WI 53705 <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> Site Plan drawn to scale <br /> ( 268-4777 (608)220-7777 CONTRACTOR INFORMATION and includes dimensions <br /> AGENNT T INN FOORMRM ATION CONTRACTOR NAME <br /> La Cr NAME SAME AS AGENT J Site Plan including location <br /> La Crosse Sign Company of well/septic <br /> AGENT ADDRESS CONTRACTOR ADDRESS <br /> 2242 Mustang Way <br /> State,Zip) (City,State,Zip) <br /> Madison,WI 53718 0 Site Plan approval from <br /> PHONE PHONE <br /> (608) 222-5353 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS 0 Floor plans to scale <br /> to resakQl acrosseslgn.com <br /> PROPERTYiLOCATION INFORMATION (http://accossdane.co.dano.wi.usq Elevation of property <br /> PARENT CU•• NT Z&NINO: A •EAGE: <br /> PARCEL 0,c s4 frontage drawn to scale. <br /> PARCEL 03210709-354-9810.3 C-2 <br /> NUMBER SECTION: Driveway permits <br /> TOWNSHIP: 35 1�4: SE y4%. SE <br /> T07NR09E TOWN OF MADISON (state,county,town) <br /> ADDRESS: 2740 SKI LANE ❑Sanitary permits <br /> LOT 1 SUBDIVISION BLOCK/LOT (public,private) <br /> CSM: 780 <br /> T r REVI <br /> ss In the buidling <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: <br /> Remove the existing channel letters and reused part and add new letters to show both business U onlfl9 DISct <br /> . ❑This project is a new building or structure. ;Ct Permitted Use? <br /> IN This project is an addition/alteration to an existing building or structure. 0001 ire <br /> SANITARY SERVICE: PERMIT NUMBER: (qew/exts Igg)' <br /> EWER �EPTIC <br /> HEIGHT IN FEET. 1 NUMBER OF STORIES: (Not including basement) 0 W�+ tli�a d O0dPt8 <br /> 1.0 10,4 0{ ittacttt�taht) <br /> AREA TO NEAREST SQUARE FOOT. ' <br /> (Outside dimensions Including unfinished area,attached garages and above grade decks or porches) 0`EroslonQ. ifttroi permit,• <br /> BASEMENT: iST FLOOR: TOTAL SQUARE FOOTAGE: 4. .(($4pes1 dIstiurl ante,4. l'''644000'' <br /> 2ND FLOOR: 3RD FLOOR: 70.1 <br /> Q=1R,evtew tlen Su ►ey. <br /> >stia a�va Isltat�oplons. <br /> ESTIMATED CONSTRUCTION COST: ,� ♦ ♦ .♦ a -4 $ 3,800.00 <br /> (Please round to nearest dollar) <br /> Yes o Don't know <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? QYes ONo 0Don't know <br /> 2. Is there a wetland or floodplain on or near the property? <br /> 3. Have you talked with the township about your project and are they in agreement? []Yes 0No <br /> 4. Has there been a zoning permit issued for this property In the past 5 years? [Yes eve blank if none) <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal#�� (leave <br /> o [Don't know <br /> 6. Is a location survey required? (see reverse) Yes �o <br /> 7. Is this to correct a violation? <br /> (Continue lon Back) —+SIGNED ONE►■ <br /> 645412(4Ne) <br />