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4pCg . tc)./-ek I <br /> ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CU •TOMER TO PROVIDE <br /> OWNER NAME <br /> Autumn Wood Storage LLC <br /> Ng ping Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) eed Restriction; CSM <br /> 4667 County Road B Oregon WI 53575 ariance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)225-8064 autumnwoodstorage @ charter.net ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Waylon Kannenberg Morton Buildings ❑Site Ian' cluding I°�at o <br /> AGENT ADDRESS CONTRACTOR ADDRESS of e eptic ! V <br /> 4667 County Road B WI190 American Street 11 <br /> (City,State,Zip) (City,State,Zip) ❑ tbacks <br /> Oregon WI 53575 Ixonia WI 53036 <br /> PHONE PHONE ❑Site Plan proval from <br /> (608) 225-8064 (920) 261-9151 ppli e township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> wakk @charter.net neal.wiebelhaus @mortonbuildings.com Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) e Elevation of prope <br /> PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P <br /> ❑PARCEL 0810-243-4567-0 C-2 2.30 frontage draw scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Burke 24 '/4: SW WA: SW ❑Drivewa ermits <br /> ADDRESS: (state, ounty,t n) <br /> 5326 Maly Road (Wood) <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary rmits <br /> 7 Wood Ger Development (public rivate) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> - s ^ ) Oil A <br /> Building D • ni storage facility vy 17 Zoning District <br /> . s project is a new building or structure. I►/ Permitted Us- <br /> ['This project is an additio Iteration to an existing buildi o tructure. <br /> SANITARY SERVICE: PERMIT NUMB : Li Rural A,d es <br /> FIEVVER EPTIC (new/e ' tin• <br /> HEIGHT IN FEET: NUMBER OF 0 E . (Not including basement) <br /> 8.0 1,0 ❑ Wetlan oodplain/ <br /> AREA TO NEAREST SQUARE FOOT: Shor and (attac ent) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionCO of permit <br /> j TOTAL SQUARE FOOTAGE: , (slopes sturbance, <br /> fillip cress) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 10,128.0 <br /> ❑ Review Location Surve e <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) -♦ -+ ♦ ♦ ♦ $ 290,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? :Yes ❑✓No ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes RI ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? t/ es <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? es o <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) es Olo ['Don't know <br /> 7. Is this to correct a violation? es W si 44 i 1 APPLICATION MUST BE SIGNED <br /> 545-11214/08) Q-v( (Continue on Back) —o• —► <br /> I 0 C <br />