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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web.App <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME T C e- 2— <br /> Nob Hill Investments LLC <br /> OWNER ADDRESS(Number,Street,City,State,Zip) \2 ,_ Zoning •Status;CUP, <br /> 10 E Doty Street Suite 300 Madison,WI 53703 '1 J Deed Restriction;CSM lc 0 l� <br /> y r � i Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS Y ;, <br /> KSite Plan drawn to scale 5�4�� <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Ryan Signs,Inc. Ryan Signs,Inc. &site Plan including location /0S- <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 3007 Perry Street 3007 Per Street ,e�,� <br /> ry ry 4 O <br /> (City,State,Zip) (city.State,Zip) ��"CC Setback <br /> Madison,WI 53713 Madison,WI 53713 <br /> PHONE PHONE Site Plan approval from <br /> (608) 271-7979 (608) 271-7979 applicable township. <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> mbgrowneyselene @ryansigns.net mbgrowneyselene@ryansigns.net rd Floor plans to scale 72....._ <br /> PROPERTYILOCATION INFORMATION (http://accessdane.co.dane.wl.usl) <br /> PARENT PARCEL NUMBER: CURRE ONING: ACREAGE: evation of property <br /> ❑PARCEL 032/0709-361-4001-0 — Z frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: S TI <br /> • Madison ; l/4; l0 t r 1/1/4.g 0 Driveway permi oi <br /> ADDRESS: state,county, OM <br /> 45 Nob Hill Road <br /> CSM: LOT SUBDIVISION BLOCK/LOT 4KS.,• -∎ permits <br /> publi •rivate) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: /!� I <br /> Replace existing monument sign with new monument sign on existing structure V)C 3x a g'Zoning District C ' 2- <br /> . EThis project is a new building or structure. k /I 6 I/ <br /> ,Permitted l,ls ? <br /> This project is an addition/alteration to an existing building or structure. 0/V <br /> SANITARY SERVICE: PERMIT NUMBER: %Rural Ad. - s <br /> NEWER )EPTIC (new/ <br /> HEIGHT IN FEET: i NUMBER OF STORIES: (Not including basement) •g / 0 W=_ loodplain/ � <br /> / ° oreland attachment) 4_ <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: i ST FLOOR: �ErosionCOntrol permit <br /> / ,`, TOTAL SQUARE FOOTAGE: +, (slopes,disturbance, <br /> filling/access) A <br /> 2ND FLOOR: 3RD FLOOR: ,+ <br /> / Review Location Survey 4 <br /> ESTIMATED CONSTRUCTION COST: . _, ♦ ♦ ♦ $ and available options. / <br /> (Please round to nearest dollar) �V <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ✓ Jo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? Des ( to ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement'? Des Ow <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Des ❑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).. Des EINo ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ✓[No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) ♦ –0 –0 <br /> 545.112(4/08) <br />