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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 /> Iron Workers 383 <br /> ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 1602 S Park Street,Room 226,Madison,WI 53715 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (608)335-3162 ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Sullivan Design Build ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1314 Emil Street <br /> (City,State,Zip) — (City,State,Zip) ❑Setbacks <br /> Madison,WI 53713 <br /> PHONE PHONE ❑Site Plan approval from <br /> (608) 257-2289 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> nate @sullivandesignbuild.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (httpJ/accessdane.co.dane.wi.us!) ❑Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> Q PARCEL 251/0810-163-0301-8 2.00 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> City of Madison 1/4: /4+/: ❑Driveway permits <br /> ADDRESS: - (state,county,town) <br /> 5501 Manufacturers Drive <br /> CSM: 10 642 LOT 1 SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> The Center for Industry&Commerce (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> New Training Facility LI Zoning District <br /> . IV 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:5 ❑ Rural Address <br /> EWER �EPTIC ,501 (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 25.0 1.0 ❑ 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 /> 0.0 11,990.0 , TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> filling/access) <br /> '2ND FLOOR: 3RD FLOOR: 11,990.0 <br /> ❑ Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -+ -I. -+ -I. -o. 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? DYes MINo EDon'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? Eyes ✓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) ['Yes ❑No IN Don't know <br /> 7. Is this to correct a violation? ❑Yes 151No <br /> \ <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) —► -+ -* <br /> 545-112(4/08) <br />