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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 /> Gary Brunner ❑ Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 4597 Cty Hwy P <br /> Variance(# <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608) 444-5946 <br /> ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Athens Gyros Progressive Designs ❑ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 23 Glaciers Edge Square 5440 Willow Rd. , Ste . l0l <br /> (City,State,Zip) (City,State,Zip) ❑ Setbacks <br /> Cross Plains, WI 53528 Waunakee, WI 53597 <br /> PHONE PHONE ❑ Site Plan approval from <br /> (608) 445-4967 (608) 695-6303 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> nick @progressivedesigns .net nick @progressivedesigns .net ❑ Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (httpJ/accessdane-co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑ PARCEL 020/0707-034-9000-4 Al EX 32 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> Cross Plains 03 1/4; SE 1/1/4; SW Cl Driveway permits <br /> ADDRESS: (state, county,town) <br /> 4597 Cty Hwy P <br /> U Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> metes & bounds (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> DIRECTORY SIGN for Athens Gyros Cl Zoning District <br /> . ®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 /> J SEWER ]SEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> none ❑ 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 /> 1 TOTAL SQUARE FOOTAGE: 1 (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> (Copy Area = 48 sq.ft.) <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ 4 0 0 and available options. <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? J Yes ❑No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ❑No J Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? Yes* No *No Town sign ord. <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) l]Yes J No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ®No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -+ <br /> 545-112(4,03) <br />