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DANE COUNTY <br /> C Zoning Division E LCD P II T <br /> Room 116, City-County Building <br /> t Q 210 Martin Luther King Jr. Blvd. <br /> Conditional Use A lication Madison, Wisconsin 53703-3342 <br /> FSl9 .. pp Phone: (608) 266-4266 <br /> Fax: (608) 267-1540 <br /> Application Fee:$486 Mineral Extraction:$1136 <br /> Items required to be submitted with application: <br /> o Written Legal Description of Conditional Use Permit boundaries <br /> o Scaled drawing of the property showing existing/proposed buildings, setback <br /> requirements, driveway, parking area, outside storage areas, location/type of exterior <br /> lighting, any natural features, and proposed signs. <br /> o Scaled map showing neighboring area land uses and zoning districts <br /> o Written operations plan describing the items listed below (additional items needed for <br /> mineral extraction sites) <br /> o Written statement on how the proposal meets the 6 standards of a Conditional Use <br /> Owner bQcle, (�(lam ► S� Agent <br /> C� II <br /> 1f� <br /> Address JQ SC,J� l Address -.wow i. <br /> Phone // // :i4 60.1 .5- 5-08- Phone I' <br /> (((9.g S to QS- o?/-/- .,.--. <br /> Email r Email <br /> Parcel numbers affected: .05-08 - 1 3a- ' 7 Town: A/ic1%v 6e Section: /6,03 <br /> Property Addre s: /.9 6 8- $wezSo� <br /> &1/ vF I/e c S35 - <br /> • <br /> Existing/Proposed Zoning District: 4 -1 t A 6:S fed <br /> 4 <br /> o- Type of Activity proposed: Nticirdirr7& fes;31:0 d,(t'rcc her S- <br /> Separate checklist for mineral extraction uses must be completed. <br /> o Hours of Operation <br /> . • . o Number of emiloyees <br /> o Anticipated .stomers <br /> o Outside storage <br /> o Outdoor activities <br /> o Outdoor lighting <br /> o Outside loudspeakers <br /> o Proposed signs <br /> o Trash removal 4 <br /> o Six Standards of CUP (see back) <br /> The statements provided ar= ue and provide an accurate depiction of the proposed land use. I authorize that I am the owner or have permission to act <br /> on behalf of the owner of .roperty. <br /> Submitted By: Date: / -f' l c <br /> � � <br />