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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME ,�1 / <br /> Roger Hansen 1'1 Zoning Status; CUP; (—' <br /> OWNER ADDRESS (Number,Street,City,State,Zip) seed Restriction;CSM ,.- <br /> 646 Chatham Terrace Madison,WI 53711 Variance(# ) ..) 3/ <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)223-2080 (608)469-2494 roger @thelittlebigloadlaundromat.com Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Grant Signs(DP Industries LLC) ,Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS offoaYf1rs <br /> 2810 Syene Rd. ' t [� <br /> (City,State,Zip) (City,State,Zip) Setbacks y -40 ©/_ <br /> Madison,WI 53713 <br /> PHONE PHONE Site Plan approval from <br /> (608) 838-7794 app:,:.: • nship. A! 4 <br /> E-MAIL ADDRESS E-MAIL ADDRESS ` <br /> Dan @GrantSigns.net i% loor plans to sc- - <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) Elevation of <br /> PARENT PARCEL NUMBER: CURR NT ZONING: ACREAGE: property <br /> El / <br /> PARCEL 032/0709-352-8720-6 C-1 0.46 frontage drawn to scale. 7 <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Madison 35 1/4: NW %/ : NW Drivewa • its <br /> ADDRESS: (state,6120 own) <br /> 2119 Fish Hatchery Rd. Madison, WI 53713 <br /> didq <br /> CSM: LOT SUBDIVISION BLOCK/LOTS permits <br /> ubl c fermi) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> (1)Non illuminated wall sign replacing existing wall sign(1)Painting existing awning Red and applying new vinyl graphics to front face Zoning District <br /> . ❑This project is a new building or structure. ,Yx Permitted Use? 6 3/ <br /> 51 This project is an addition/alteration to an existing building or structure. W a 1( S I <br /> SANITARY SERVICE: PERMIT NUMBER: 0 Rural Addr- -s <br /> �' <br /> EWER FIEPTIC (new 'sting) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 13.0 <br /> 1 We /Floodplain/ <br /> AREA TO NEAREST SQUARE FOOT: re in (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) _ <br /> rosionControl permit <br /> BASEMENT: 1ST FLOOR: .�7 `, <br /> /7 + TOTAL SQUARE FOOTAGE: 4 slopes,disturbance, /V <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 30.0 eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. 4_ <br /> (Please round to nearest dollar) ♦ ♦ ♦ -' *+ ' • '/ <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ✓INo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes No ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [Yes laio <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 alo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ialo <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ■ -► <br /> 545-112(4/08) <br />