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` - I G._ i s N a wR. ( 15 ,_,, b (,,� <br /> ZONING PERMIT APPLICATION www.countyofdane.coim� SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME SUN PRAIRIE INVESTORS LLC <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> Deed Restriction; CSM <br /> 5735 TWIN LANE ROAD, MARSHALL,WI 53559 <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)837-9367 (608)209-9086 rick @cardinalhvac.com ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Stephen Franklin Able Signs&Lighting ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> W8246 N Crystal Lake Road W8246 N Crystal Lake Road <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Beaver Dam,WI 53916 Beaver Dam,WI 53916 <br /> PHONE PHONE ❑Site Plan approval from <br /> (920) 344-6566 (920) 219-9556 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> sfranklin @ablesign.net sfranklin @ablesign.net ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> ❑PARCEL 014/0810-123-9000-7 C2 2.50 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> TOWN OF BURKE 12 1/4. 1/41/4. ❑ Driveway permits <br /> ADDRESS: (state, county, town) <br /> 3361 BROOKS DRIVE <br /> CSM: 4,147 LOT 1 SUBDIVISION BLOCK/LOT ❑ Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> NEW SINGLE FACE WALL SIGN ❑ Zoning District <br /> . ❑This project is a new building or structure. ❑ Permitted Use? <br /> 151 This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> FIEVVER r)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES (Not including basement) <br /> 18.0 1.0 LI Wetland/Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1 ST FLOOR: 1-1 ErosionControl permit <br /> j TOTAL SQUARE FOOTAGE: j (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ —' —' —' ♦ ♦ $ 5,133.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ['Yes 1511No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Eves f No QDon't know <br /> 3. Have you talked with the township about your project and are they in agreement'? ❑Yes ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ONo <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 ❑No ODon't know <br /> 7. Is this to correct a violation? ['Yes FANo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ —► —► <br /> 545-112(4/08) <br />