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N,�_ t „dot- ________, r , ,2,* Pq )/6(. Vt/ 6T-r1) MISCELLANEOUS APPLICATION 4 44 At ©"' / k DEPARTMENT OF PLANNING FAX CITY of 300 East Main Street, Sun Prairie, WI 53590-2227 Sun Prairie (608)825-1107(608)825-1194 LAND DEVELOPMENT APPLICATION FORM Applications will not be processed unless all required information for the specific application type is submitted and applicable fees paid by 12:00 NOON on the application deadline date. No partial applications will be accepted and final acceptance will be determined by the assigned staff person after the initial submission. Applicant OFFICE USE: Initials/• Staff Initials: 11 Letter of Intent(6 copies) (// Predevelopment Agreement signed(1 copy) V Application checklist complete and signed(1 copy) Applica t i orm n: A/i Mil ST 41 E5 Name: k1eA M11+ 6Tb" Address: P,0, eigc /67-, SUAI P,-I,ie Phone Number: a. , le ax Number: _ E-mail Address: C1J. i?,l'jh 6L .c6 vvhi-i-eetKevearvi ,CCU E .2' Ownel?t3iform o ation: ,° E Name:_ XJI45_ a 4 VEt-L-e- Address: 33`32 IJ t b1<5 be, StIA/P4410 E e, L° Phone Number: .0�,243.I/6/062 Fax Number: E-mail Address:dat:-t'de k aektY- g ', Primar contact informs ion: a - Name: Yl.-f'h4lL kik 1-ek e Address: aito l /A Iv thiitJLU 6r.•' PAM Phone Number:CODe. ,2-2-“Fax Number: E-mail Address 2,C23 tia,i dr i-e4X-k s^&1144a t a Property Informati n: ,/�,/ 4 �- v) o Legal Description: C mi-Ach 30.4-1e 4 �" i M1 b (Metes and bounds and other complex descriptions must be submitted on diskette in Microsoft Word format) °' Parcel Number: Address/Location: 33qZ_ eg.00kS 1W,5c.Ut1 f l 0 t Ej w/ Q Existing Zoning District: Existing Land Use: Brief Description of Project: keZOA ✓ 3.- /'2- IOKS 10 /Qri1 6Gl4 PLEB IAL To g,Li- , A1'0 CI---AAftSES W I LL bE M/'I-ID TD THE OUTS)L E / i 61.1.1 i-bii/a . P S •AL-/it/ 411 ' FC CE" Property Owner Authorization(required l _ K4 l'AITIbi- i (Signature or signed letter of authorization) Applicant Signature(if different from owner): elei _ k ` OFFICE USE Received in Planning Dept.office by Date: Fee Paid: Check#: Project Number: