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SUPPLEMENT to Web-App# <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION OUST• ` R TO PROVIDE <br /> OWNER NAME <br /> Dane County Public Works <br /> ig oning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1919 Alliant Energy Center Way, Madison, WI <br /> Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> e Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> J.H. Findorff& Son Inc. ❑Site Pla ' luding location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of septi. <br /> 300 S. Bedford St. <br /> City.State.Zip) (City.State.Zip) tbacks <br /> Madison, WI 53703 <br /> PHONE PHONE a PI proval from <br /> 608-843-8528 ap able ownship. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tolson ' findorff.com oor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ation of property felikd <br /> ❑NUMBER 01 OC1-1S3^goon-S ! p-/SIRS frontage drawn to scale. <br /> TOWNSHIP: S CTION: II <br /> e—cl D,,--- ,s ,/_ S� 1/1/4. ❑Drivew mits <br /> ADDR ss: (sta ,co ,town) <br /> 1 " <br /> CSM: / Q or £ `� , 6UBD�ISION BLOCK/LOT <br /> El Sa i - • mits <br /> (pub'-,p ' ate) <br /> PROPOSED PROJECT INFORMATION TAFF`R IEW <br /> PROJECT DESCRIPTION: <br /> Two new loading docks and canopy. ont District <br /> . <br /> This project is a new building or structure. L�-Wer pitted Use? <br /> El This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBE /� LI Rural Address <br /> �EWER FIEPTIC N A (new ..' ng <br /> HEIGHT IN FEET: NUMBER OF S ORIES: (Not including basement) <br /> 1 .5 ❑ Wetla /F dplain/ <br /> Sh (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ❑ Ero CO of permit <br /> BASEMENT: 1ST FLO <br /> cinak j TOTAL SQUARE FOOTAGE: j (slopes ' turbance, <br /> `J <br /> fill' gI SS) <br /> 2ND FLOOR: 3RD FLOOR: v/j l\C2 <br /> /\.JI eview Location Survey <br /> ESTIMATED CONSTRUCTION COST: $ �� and available opt' ns. <br /> (Please round to nearest dollar) --► ♦ ♦ --► <br /> ilt <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yeslo QDon'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 `L—��" <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? "'Res Ulo <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 ! o ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes :,'N o <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -i -+ -* <br /> 545-112(4/081 <br />