Laserfiche WebLink
/1.0 S <br /> 3�ai8 <br /> COMMUNICATION TOWER INFORMATION FORM(CTIF) <br /> CONTACTS -� <br /> Property Owner's Name Roye,� ( ,� D©,,N R 1 S o LL <br /> Property Owner's 6 6 S NoR L4 4 ) 20 40 66-1../-c:V LLCM tA)1 5350!� <br /> Mailing Address Street City State ZIP <br /> Property Owner's Phone Number ( (,O g ) .2/9 02.32_ <br /> Agent's Name&Affiliation S0-i-c L,rRL LL y TUBS L <br /> Agent's Relationship to Property Owner `K r ,?4y �u5$eG . li?z�SS, LLZ <br /> Agent's Relationship to the Proposed Tower (e.g. wireless U GV <br /> service provider,site acquisition firm,tower builder,etc.) ICI cr t�I e,w/Cl t; r CoN T�•AC r-o 2 <br /> Agent's Mailing Address /024 50../714 57 ill sr �.t/ESr ,I1-Lis W <br /> Street City State ZIP <br /> Agent's Phone Number ( K/4 ) Co 7 -3770 0Fly cr <br /> PROPOSED ACTION <br /> Current Zoning A 1 E ' : C x c.Lus lvt 1:3 . CUP Acres /004A/oo i_ /OOoo A <br /> Proposed Zoning(only if rezoning) N .A Rezone Acres(if applicable) /✓Q <br /> Have the property owner and the agent/tower sponsor formally completed a binding No <br /> letter of intent, option to lease, or lease? Please attach a letter from the property <br /> owner(s)consenting to the application. Circle One <br /> No <br /> If applicable,does the lease area coincide with the proposed CUP area? <br /> Circle One <br /> LOCATION <br /> Town PR-114 ROSE <br /> PLSS location(Township,Range,'A'Vs Section) 5G-,- -5 -7 NC Vti 5 ET `! - <br /> Parcel Number(s) O y S/ 0501 a oi4 - 8000-1-1 <br /> S t r e e t Address(or Proximity t o N e a r e s t Address) (.0 S 5 is/0P-64/40 (.D:i 3e U vlllc 5 3506 <br /> Coordinates in Decimal Degrees 4;t. 139 .2 2,j°� - 89428 `f o <br /> (00.000000 Lat.,-00.000000 Long.) <br /> Is the subject property located in the Height Limitation Zoning Overlay District (HLZO), Yes No <br /> roughly within three miles of the Dane County Regional Airport(check with Zoning staff)? Circle One <br /> H:\Zoning\Zoning Division Documentation\Informational Materials\Communication Towers\Communication Tower Application <br /> Packet 09-2010.doc <br /> Page 6 of 10 <br /> 210 Martin Luther King Jr.Blvd.v Room 116,City-County Bldg.4 Madison,WI 53703-3342 s°Phone:608.266.4266 4 Fax:608.267.1540 <br />