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DANE COUNTY ZONING PERMIT DCPZP-2015 00911 Page 1 of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BADGER BUS LINES INC (608) 838-7794 Grant Signs(DP Industries LLC) 608-838 <br /> BILLING ADDRESS(Number:Street) ADDRESS(Number,Street) <br /> 5501 FEMRITE DR 2810 Syene Road <br /> (City.State.Zip) (City,State,Zip) <br /> MADISON, WI 53718 Madison, WI 53 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Dan @grantsigns.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0709-362-4142-2 TOWN OF MADISON 36 NW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 200 W BELTLINE HWY <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 2 JACOBS,W. H. AND BARKER'S, E. S. SUBDIVISION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: CENSUS CODE <br /> C-2 Commercial 3.7745 Description:Install(1)illuminated wall sign on front elevation and 329- Other <br /> District re-facing(1)double-sided pylon sign cabinet <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Public <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway DCPREZ-1965-01066 <br /> 0 YES NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 16 Sq.Ft. Sq.Ft.277 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $200.00 <br /> I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of this permit renders this zoning permit null and void and subject <br /> to enforcement action. <br /> I acknowledge that I am responsible for complying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGN- RE: • n r/A' = f 7 DATE: <br /> Ordinances.Any unauthorized change from the information or t <br /> plans submitted will invalidate the permit. r • 4 f 1./1/ 2_of- <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 11/11/2015 RLB <br /> YES ® NO DATE REVIEW 0 INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br /> O'!i���5 <br />