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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME SRB Lot 5 LLC <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> PO Box 620305 Middleton WI. 53562-0305 Variance(# ) <br /> HOME PHONE I CELL PHONE E-MAIL ADDRESS <br /> (608)333-4154 jim @thestorageguy-madison.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> James R.Wills Fanning Construction LLC ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> PO Box 620305 PO Box 2101 <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Middleton,WI.53562-0305 Janesville, WI. 53547-2101 <br /> PHONE PHONE <br /> ❑Site Plan approval from <br /> (608) 333-4154 (608) 295-2606 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jim @thestorageguy-madison.com kfanning @fanningconstruction.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑Elevation of property <br /> ❑ <br /> PARENT PARCEL NUMBER: _ CURRENT ZONING: ACREAGE: <br /> PARCEL r7 c-2 <br /> frontage drawn to scale. <br /> NUMBER 4o8,3 s' q5-J <br /> TOWNSHIP: SECTION: <br /> Springfield 1/4: <br /> WA: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 6840 Schneider Road Middleton WI 53562 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> 5 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Warehouse ❑ Zoning District <br /> . 12 This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> rEWER )EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 1.0 ❑ Wetland/Floodplain/ <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: • <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ ErosionControl permit <br /> 0.0 9,370.0 ,, TOTAL SQUARE FOOTAGE: 4, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 0.0 0.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available o tions. <br /> (Please round to nearest dollar) "+ -+ -* '' -♦ $ 625,000.00 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 o ['Don't know <br /> ❑✓ <br /> 3. Have you talked with the township about your project and are they in agreement? Yes LVo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑✓Yes ao <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) ['Yes OW ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4i08) /_f Ft, - a y f . (Continue on Back) <br /> -► -► -► <br />