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• <br /> ZONING PERMIT APPLICATION ww county�ofdanl�,Cf SUPPLEMENT to Web-App # <br /> w <br /> PROPERTY OWNER INFORMATION <br /> DER NAME CUSTOMER TO PROVIDE <br /> Kwik Trip Inc. <br /> OWNER ADDRESS(Number,Street,04 Sm1a,zip) 0 Zoning Status;CUP; <br /> 1626 Oak St(PO Box 2107)La Crosse,WI 54602 Deed Restriction;CSM <br /> ) <br /> HOME PHONE -CELL PHONE EMAIL ADDRESS Variance(# <br /> (608)793-6433 bnovyakw9drip, n (agent for Kw*Trip) <br /> AGENT 0 Site Plan drawn to scale <br /> GENT INFORMATION <br /> CONTRACTOR INFORMATION and indudes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Cindy Bluske (agent for La Crosse Sig)) La Crosse Sign Co. 0 Site Plan inducting location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of weWseptic <br /> 1450 Oak Forest Drive 1450 Oak Forest Drive <br /> (C%State.Zp) (City,State.Zip) <br /> Onalaska,WI 54650 Onalaska,WI 54650 ❑Setbacks <br /> PHONE <br /> PHONE [Site Plan approval from <br /> (608) 781-1450 (608) 781-1450 applicable township. <br /> EMAILAOORESS E-MAIL ADDRESS <br /> Cinyssesign.com cindybelaaossesign.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http:liaccessdane.co.dane.wi.us!) <br /> [PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE 0 Elevation of property <br /> NUM3EIR 070829281056 81,C1 Commercial frontage drawn to scale. <br /> TOWNSHI: . SECTION: <br /> Town of WCddletorh y: 1/4,4: 0 Driveway permits <br /> ADDRESS: <br /> Kwik Trip 7587 W. Mineral Point Road, Verona, WI 53593 (state,�t,nty. ) <br /> CSM 7,415 LOT 2 SUBDIVISION BLOCKILOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION <br /> PROJECT DESCRIPTION: r'�'/Ir - w/�REVIEW <br /> Update existing gas price sign to LED lit pricers and change :.:.:. .�'f, to elec. :-• - center ❑ Zoning District <br /> • [This project is a new building or structure. <br /> ❑ Permitted Use? <br /> ['This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE PERMIT NUMBER: ❑ Rural Address <br /> (new/existing) <br /> HEIGHT IN FET t NUMBER OF STORIES: (Not including basement) <br /> ❑ WetlancURoodplaw <br /> attachmen <br /> AREA TO NEAREST SQUARE FOOT: St10re18rlr! ( U <br /> ( `Outside dimensions including unfinished area,attached garages and above grade decks or porches) permit <br /> ,� is oo�R,p ❑ ErosionContrd.e.a04 ✓e. 4 TOTAL SQUARE FOOTAGE + (slopes,disturbance, <br /> 2ND FL•• 3RD FLOOR: Ong/access) <br /> a:cr 186 <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ i ❑ � Survey <br /> (Please round to nearest dollar) $ 40,000.00 . <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes Dlo NH 't know <br /> 2. Is there a wetland or floodplain on or near the property? []Yes 1 4. . 't know <br /> 3. Have you talked with the township about your project and are they in agreement? Dies N • <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes [}I0 <br /> 5. Is this ,,�y:.• :,y:.(:,. .;I ,: At I,:a UP/variance •:.i appeal# ) leave blank if none <br /> 6. Is a location survey required? (see reverse) �/ es [bon't know <br /> 7. Is this to correct a violation? <br /> l r/ <br /> APPLICATION MUST BE SIGNED <br /> 545-112 MS) on Back) -, - . -► <br />