Laserfiche WebLink
ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App# <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Road Ranger ❑ Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 2762 County Highway N Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Doyle Signs, Inc. Doyle Signs, Inc. ❑ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 232 w. Interstate Road 232 W. Interstate Road <br /> (City,State,Zip) (City,State,Zip) ❑ Setbacks <br /> Addison, IL 60101 Addison, IL 60101 <br /> PHONE PHONE Li Site Plan approval from <br /> 630-543-9490 630-543-9490 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Permit .d. e i• v P• u•is .d. e i- em <br /> ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us!) <br /> PARENT PARCEL NUMBER: CURRE ZONING: ACREAGE: ❑ Elevation of property <br /> ❑ PARCEL MBER frontage drawn to scale. <br /> NU <br /> TOWNSHIP: SECTION: <br /> 1/a: '/4'/a: ❑ Driveway permits <br /> ADDRESS: <br /> (state,county,town) <br /> 2762 COunty Highway N Cottage Grove, WI ❑ Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION i jYv t - q ) <br /> PROJECT DESCRIPTION' " � <br /> REplacement face for Diesel Canopy sign T,,'�':' '�: ' ` <br /> . ❑This project is a new building or structure. <br /> ®This project is an addition/alteration to an existing building or structure. , . ' .:!,: � <br /> SANITARY SERVICE: PERMIT NUMBER I .r ,•,€� ,, ,, '= <br /> ❑SEWER ❑SEPTIC <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) es <br /> AREA TO NEAREST SQUARE FOOT: ) i g, �lnt '; 4 <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ,: <br /> BASEMENT: 1ST FLOOR: <br /> ,, TOTAL SQUARE FOOTAGE 4, %-:-, :" 'l 'I :4,;', t <br /> 2ND FLOOR: 3RD FLOOR: <br /> ESTIMATED CONSTRUCTION COST: <br /> ♦ ♦ ♦ ♦ .-■ ♦ (e € s ��3 j <br /> (Please round to nearest dollar) ,�, ti, <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes ❑No LI Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes I No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? LILI Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? �{ Yes ❑No <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 ❑No ®Don't know <br /> 7. Is this to correct a violation? ❑Yes I No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► ■ —► <br /> 545-112(4/08) <br />