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Application Date C.U.P Number <br /> Dane County 07/01/2016 DCPCUP-2016-02355 <br /> Conditional Use Permit Public Hearing Date <br /> Application 08/23/2016 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME Phone with Area AGENT NAME Phone with Area Code <br /> DONALD P SQUIRE JR Code NATHAN WARD (414)788-1327 <br /> (608)873-4663 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2046 NORGAREN RD 1200 RIVA RIDGE <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 Racine,WI 53402 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> squire.donald @gmail.com nward @buellconsulting.com <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF CUP ADDRESS OR LOCATION OF CUP ADDRESS OR LOCATION OF CUP <br /> SE Corner of CTH B and Spring Rd <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> PLEASANT SPRINGS 27 I <br /> PA*CIO,.No off**,...INVOLVED PARCEL NUM**N$INVOLVER; PARCEL NUA ,INVOLVED <br /> 0611-271-8730-0 --- -- <br /> CUP DESCRIPTION <br /> 125'Monopole communication Tower(extendable to 160') <br /> DANE COUNTY CODE OF ORDINANCE SECTION ACRES <br /> 10.194 .23 <br /> DEED RESTRICTION Inspectors SIGNATURE:(Owner or Agent) <br /> REQUIRED? Initials <br /> 0 0 <br /> Yes No <br /> AMA1 <br /> Applicant PRINT NAME: <br /> Initials <br /> DATE: <br /> Form Version 01.00.03 <br />