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DANE COUNTY Zoning Division <br /> PLANNING <br /> DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> Conditional Use Madison, Wisconsin 53703-3342 <br /> Ise <br /> Faso �,a l.� V Application <br /> p lication 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 /> • 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 BLOOMING GROVE, TOWN OF FIRE DEPT Agent County of Dane <br /> Address 1880 S STOUGHTON RD Address 210 Martin Luther King Jr Blvd <br /> MADISON WI 53716 Madison WI 53703 <br /> Phone Phone <br /> (608) 223-1104 (608) 266-4993 <br /> Email bgadmin @blmgrove.com Email hilbert.hans @countyofdane.com <br /> Parcel numbers affected: 0710-161-9640-9 Town: Blooming Grove Section: 16 <br /> 1880 S STOUGHTON RD <br /> Property Address: <br /> Existing/Proposed Zoning District : C-2 Commercial (DCPREZ-0000-00513) <br /> o Type of Activity proposed: Governmental Uses <br /> Separate checklist for mineral extraction uses must be completed. <br /> o Hours of Operation See Attached. <br /> o Number of employees <br /> o Anticipated customers <br /> o Outside storage <br /> o Outdoor activities <br /> o Outdoor lighting <br /> o Outside loudspeakers <br /> o Proposed signs <br /> o Trash removal <br /> o Six Standards of CUP (see back) <br /> The statements provided are true and provid an accurate depiction of the proposed land use. I authorize that I am the owner r hav permission to act <br /> on behalf of the owner t property <br /> Submitted By: Date: ' 4-5' <br /> d r� <br />