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DANE COUNTY . Zoning Division
<br /> PLANNING EVELOPM ENT Room 116,City-County Budding
<br /> or.9� 210 Martin Luther King Jr.Blvd.
<br /> k , °r
<br /> Madison,Wisconsin-53703-3342
<br /> ' ' Conditional Use Application Phone: (608)266-4266 •
<br /> �ti fax: (608}267-1540
<br /> Items required to be submitted with application:
<br /> o Legal Description of the proposed Conditional Use Boundaries
<br /> Legal description of the boundaries of the intended use. The description may be a lot in a Certified
<br /> Survey Map or an exact metes and bounds description. The description shall include the area in acres
<br /> or square feet.
<br /> o Site plan of the proposed use
<br /> The site plan shall include property lines,proposed conditional use boundaries,any existing or
<br /> proposed buildings,vehicle parking areas and drive paths,outside storage or activity areas,storm
<br /> water management features,screening or fences,and existing or proposed lightfixture.locations.
<br /> Owners Name Agent's Name t eivAra i 4- s LLL
<br /> Address 811 N HIS!( I •i
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<br /> Email Email
<br /> Parcel numbers affected: p 5/. - —I Nb{-ci 0 DSO - 2 Town: 4144' b-n Section:_
<br /> Property Address:
<br /> Zoning Distri I Pro po ed Conditional Use:,, /-)-
<br /> Hours of Operation ❑ Outside storage ❑ Outside loudspeakers
<br /> ®' Number of employees ❑ Outdoor activities ❑ Proposed signs
<br /> Anticipated customers ❑ Outdoor lighting 4,0 0 Trash removal
<br /> Provide Narrative:(Describe proposed use in detail) 4 b��- GL -c.
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<br /> I authorize that I am the owner or have permission to act on behalf oflhe owner of the property.
<br /> Submitted By: Date:
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