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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION C --TOMER TO PROVIDE <br /> OWNER NAME <br /> Autumn Wood Storage LLC V z Wing 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 I CONTRACTOR INFORMATION and includes dime :•• s <br /> AGENT NAME CONTRACTOR NAME <br /> Waylon Kannenberg Morton Buildings <br /> ❑Sit Pla • udin: I, . - •- <br /> AGENT ADDRESS CONTRACTOR ADDRESS o : septic <br /> 4667 County Road B WI 190 American Street <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Oregon WI 53575 Ixonia WI 53036 <br /> PHONE PHONE El . e Plan proval from <br /> (608) 225-8064 (920) 261-9151 :•plic a township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> wakk @charter.net neal.wiebelhaus @mortonbuildings.com V/ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ► Elevation PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: evaon Oproperty <br /> ❑PARCEL 0810-243-4567-0 C-2 2.30 frontage drawn t cale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Burke 24 �/,. SW +/1/: SW ❑Drivew er <br /> ADDRESS: (st , cou ,town) <br /> 5326 Maly Road (Wood) <br /> ❑Sani permits <br /> CSM: LOT 7 SUBDIVISION BLOCK/LOT <br /> is IC,private) <br /> Wood Ger Development J <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> .. mini storage 0•� I <br /> Bui ding A mini storage facility Q ■ Zoning District <br /> . a,- s project is a new building or structure. 4 Permitted U <br /> This project is an additio /alteration to an existing building or structure <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural SS <br /> EWER EPTIC (new/ fisting)NUMBER OF STORIES: (Not induding basement) <br /> HEIGHT IN FEET: / ,-,)( w f7 1.0 ❑ Wetland/FI dplain/ <br /> Shorel (attachme <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionCOntr ermit <br /> TOTAL SQUARE FOOTAGE: + (slopes,di rbance, <br /> 2ND FLOOR: 3RD FLOOR: <br /> filling/a ss) <br /> 6,630.0 ❑ Re ew Location Survey S <br /> ESTIMATED CONSTRUCTION COST: and available o dons. <br /> (Please round to nearest dollar) ♦ ♦ '♦ -' — -♦ $ 193,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ONo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ONo ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? D s /No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [ giNo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (I ve blank if none) <br /> 6. Is a location survey required? (see reverse) es plo ['Don't know <br /> 7. Is this to correct a violation? Des ✓❑No <br /> --14 s g,-.) , APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) —► ■ —► <br />