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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 \ oning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 4667 County Road B Oregon WI 53575 V fiance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)225-8064 autumnwoodstorage @charter.net 111 ite Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION n ' dudes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Waylon Kannenberg Morton Buildings ❑S e Plan includinJJpca�i <br /> AGENT ADDRESS CONTRACTOR ADDRESS well/septic �� <br /> 4667 County Road B W1190 American Street <br /> (City,State,Zip) (City,State,Zip) etbacks <br /> Oregon WI 53575 lxonia WI 53036 <br /> PHONE PHONE ❑S. Pla proval from <br /> (608) 225-8064 (920) 261-9151 i e township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> wakk @charter.net neal.wiebelhaus @mortonbuildings.com F oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn levation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: p P rty <br /> ❑PARCEL 0810-243-4567-0 C-2 2.30 frontage drawn to ale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Burke 24 1/a: SW %1/a: SW ❑Driveway it <br /> ADDRESS: (state, unt own) <br /> 5326 Maly Road (Wood) <br /> ❑Sanita sermits <br /> CSM: LOT 7 SUBDIVISION BLOCK/LOT <br /> sub private) <br /> Wood Ger Development <br /> PROPOSED PROJECT INFORMATION 1 STAFF REVIEW <br /> gDESCRIPTIO : g facility `/e )01( <br /> Building mini storage facili C oning District <br /> project is a new building or structure. • <br /> Permitte s ? <br /> OThis project is an addition/alteration to an existing building or tr u . <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural A e s <br /> EWER PTIC (new/e ting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> Are. LI 1.0 ❑ Wetland/Flo In/ <br /> AREA TO NEAREST SQUARE FOOT: Shore (attachment) <br /> (Outside dimensions including unfinished area, attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionC rol permit <br /> 4. TOTAL SQUARE FOOTAGE: + (slop ,disturbance, <br /> filli /access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 8,862.0 eG <br /> ❑ Review Location Surve <br /> ESTIMATED CONSTRUCTION COST: I and available options. <br /> (Please round to nearest dollar) "+ -' '-'* .- $ 258,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ONo ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Y s ,/No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? L/ es No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? glo <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (le ve blank if none) <br /> 6. Is a location survey required? (see reverse) es gliCVo ['Don't know <br /> 7. Is this to correct a violation? ❑Yes EINo <br /> APPLICATION MUST BE SIGNED <br /> say��s laioe) 7 0 (Continue on Back) -► <br />