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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Landmark Services Cooperative <br /> ei Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1401 Landmark Drive,Cottage Grove,WI 563527 Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)819-3117 (608)469-7633 mike.elder @landmark.coop <br /> 12 Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Dutton Welding&Millwright Services ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> W8895 Westbound Lane <br /> (City,State,Zip) (City,State,Zip) Setbacks <br /> Darien,WI 53114 <br /> PHONE PHONE ❑Site Plan approval from <br /> (262) 882-1500 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jon @duttonwelding.com [Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) [ Elti <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: evaon of property <br /> ❑PARCEL 071116399206 C-2 CDPREZ-0000-01147 4.40 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> • Cottage Grove 16 1�s: SE %1�4: SW ID Driveway permits <br /> ADDRESS: (state,county,town) <br /> 3977 County Highway N <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF'REVIEW <br /> PROJECT DESCRIPTION: <br /> Removing and replacing old grain bins,equipment,and receiving building. ❑ Zoning District <br /> . OThis project is a new building or structure. <br /> ❑ Permitted Use? <br /> IS This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> FIEWER 1)EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 1.0 ❑ Wetland/Floodplain/ <br /> • <br /> AREA TO NEAREST SQUARE FOOT: Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: <br /> 1—i ErosionControl permit <br /> j TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 2,112.0 ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available O tions. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ "♦ ♦ $ 2,700,000.00 p <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes Elio ['Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ✓ o ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ✓❑Yeslo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes �lo <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) Dyes 'lo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes �lo <br /> 0 3 — goo d -'�' Ca c u e <br /> e (3� APPLICATION MUST BE SIGNED♦ <br /> 545-112(4/08)> (Continue on Back) -+ -+ <br />