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DANE COUNTY Zoning Division <br /> PLANNING:: <br /> :. - DEVELOPMENT Room 116, City-County Building <br /> ; , -`' 210 Martin Luther King Jr. Blvd. <br /> Conditional Use Application Madison,Wisconsin 53703-3342 <br /> Phone: (608) 266-4266 <br /> ' � <br /> Fax: (608) 267-1540 <br /> Application Fee:$486 Mineral Extraction:$1136 <br /> Items required to be submitted with application: <br /> o Written Legal Description of Conditional Use Permit boundaries <br /> o Scaled drawing of the property showing existing/proposed buildings, setback <br /> requirements, driveway, parking area, outside storage areas, location/type of exterior <br /> lighting, any natural features, and proposed signs. <br /> o Scaled map showing neighboring area land uses and zoning districts <br /> o Written operations plan describing the items listed below (additional items needed for <br /> mineral extraction sites) <br /> o Written statement on how the proposal meets the 6 standards of a Conditional Use 1 <br /> Owner G o �r U /s(, n Agent <br /> Address A. , /A Address <br /> If Phone - Phone <br /> 60 — 91/f. `1'S 3/ <br /> Email rid j s n Q cI' a 5/Q h or)_ coon Email <br /> 1 <br /> Parcel numbers affected: c/c — / 9i- c_afk_a_Town: 0 /b/o <br /> O ll Section: <br /> Property Address: 1 C271 OC A P' <br /> p qr..- !J 41k /ate <br /> Existing/Proposed Zoning District: <br /> o Type of Activity proposed: o�r`Gz ho m� ° n Pa r rrl n <br /> YP tyP P <br /> Separate checklist for mineral extraction uses must be completed. <br /> o Hours of Operation <br /> o Number of employees <br /> o Anticipated customers <br /> o Outside storage <br /> o Outdoor activities <br /> o Outdoor lighting <br /> o Outside loudspeakers <br /> o Proposed signs <br /> o Trash removal <br /> o Six Standards of CUP (see back) <br /> The statements provided are true and provide an accurate depiction of the proposed land use. I authorize that I am the owner or have permission to act <br /> on behalf of the owner of the property. o <br /> Submitted By: Date: �' . <br />